Factors influencing yields of progenitor cells for allogeneic transplantation: Optimization of G-CSF dose, day of collection, and duration of leukapheresis
Factors influencing yields of progenitor cells for allogeneic transplantation: Optimization of G-CSF dose, day of collection, and duration of leukapheresis
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DOI：
10.1089/scd.1.1997.6.575
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发表时间：
1997-12-01
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影响因子：
--
通讯作者：
Russell, JA
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文献类型：
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作者：
Luider, J;Brown, C;Russell, JA
在85例健康供者中，用G-CSF动员造血祖细胞89次。选择三个剂量范围的G-CSF用于分析：低（4-7.4 μ g/kg）、中等（7.5-10 μ g/kg）和高（>10 μ g/kg）。75例患者（84%）在第3天达到了20 x 10（6）/L CD 34+细胞的单采目标血液水平，除1例患者（99%）外，所有患者在第4天达到了20 x 10（6）/L CD 34+细胞的单采目标血液水平。在73名供体（97%）的单次采集中，75例未经操作的移植超过了2.5 x 10（6）/kg的目标产量。在白细胞去除术之前，CD 34+细胞产量与血液CD 34+细胞水平的相关性仅为中度（r（2）= 0.32）。处理体积和累积CD 34+细胞产量之间存在密切的线性相关性，中位r（2）值为0.98（范围0.74-1.00）。第3天，高剂量组获得的CD 34+细胞产量显著低于中等剂量组（21 +/- 3 vs 29 +/- 6 x 10（6）/L处理血液，p = 0.03）。低剂量G-CSF后，第4天的产量高于第3天（48 +/- 10 vs 22 +/- 4 x 10（6）/L处理血液，p = 0.01）。在中等G-CSF剂量下，第3天和第4天的产量之间没有差异。在73/93例（78%）白细胞去除术中，CD 34+细胞产量超过收集开始时估计的血管内CD 34+细胞的100%，范围高达342%。这些数据表明，以300和480 μ g安瓿的倍数给予7.5-10 μ g/kg G-CSF的日剂量是一种方便的方案，在大多数供体中，在第3天或第4天的单次采集中获得足够的产量。测量血液CD 34+细胞水平在预测产量方面的价值有限，但在白细胞去除术期间监测CD 34+细胞产量可能有助于最大限度地减少不必要或低效的收集。
Mobilization of hematopoietic progenitor cells by G-CSF was attempted on 89 occasions in 85 healthy donors. Three dose ranges of G-CSF were chosen for analysis: low (4-7.4 mu g/kg), intermediate (7.5-10 mu g/kg) and high (>10 mu g/kg). A target blood level for apheresis of 20 x 10(6)/L CD34+ cells was reached by day 3 in 75 patients (84%) and by day 4 in all but 1 (99%). Target yields above 2.5 x 10(6)/kg for 75 unmanipulated transplants were exceeded in a single collection in 73 donors (97%). Correlation of CD34+ cell yields to blood CD34+ cell level before leukapheresis was moderate only (r(2) = 0.32). There was close linear correlation between processed volume and cumulative CD34+ cell yield, with a median r(2) value of 0.98 (range 0.74-1.00). Yields of CD34+ cells achieved on day 3 were significantly lower after the high dose than after the intermediate G-CSF dose (21 +/- 3 versus 29 +/- 6 x 10(6)/L blood processed, p = 0.03). After the low dose of G-CSF, yields on day 4 were higher than on day 3 (48 +/- 10 versus 22 +/- 4 x 10(6)/L blood processed, p = 0.01). There was no difference between day 3 and day 4 yields with the intermediate G-CSF dose. In 73 of 93 (78%) leukaphereses, the CD34+ cell yield was more than 100% of the estimated intravascular CD34+ cells at the beginning of collection and ranged up to 342%. These data indicate that a daily dose of 7.5-10 mu g/kg G-CSF, given as a multiple of 300 and 480 mu g ampoules, is a convenient regimen giving adequate yields from a single collection on day 3 or 4 in most donors. Measuring blood CD34+ cell levels is of limited value in predicting yields, but monitoring CD34+ cell yields during leukapheresis may help to minimize unnecessary or inefficient collection.