两种血细胞分离机干/祖细胞采集和移植效果的比较

背景:外周血造血干/祖细胞通过血细胞分离机进行体外收集,血细胞分离机的性能、工作状况将直接关系到采集物的特性和数量,从而直接影响受者的造血重建.目的:比较Fenwal CS-3000 Plus与Amicus两种血细胞分离机采集外周血造血干/祖细胞及受者移植效果.方法:共入选接受异基因外周血干细胞移植患者51例,Fenwal CS-3000 Plus组27例,平均年龄(34.2±10.6)岁;Amicus组24例,平均年龄(35.4±12.1)岁.比较两组采集物有核细胞数、CD34+细胞数、采集效率、红细胞与血小板采集量及造血重建时间.结果与结论:两组采集物的有核细胞数、CD34+细胞数、采集效率、红细胞采集量及造血重建时间差异均无显著性意义;Fenwal CS-3000Plus组血小板采集量明显高于Amicus组(P<0.01).结果显示Fenwal CS-3000 Plus与Amicus血细胞分离机在分离外周血干/祖细胞方面和移植效果没有差异;血小板较低被采集者使用Amicus血细胞分离机采集可能更为安全.     

两种血细胞分离机干/祖细胞采集和移植效果的比较

背景：外周血造血干/祖细胞通过血细胞分离机进行体外收集,血细胞分离机的性能、工作状况将直接关系到采集物的特性和数量,从而直接影响受者的造血重建。目的：比较Fenwal CS-3000Plus与Amicus两种血细胞分离机采集外周血造血干/祖细胞及受者移植效果。方法：共入选接受异基因外周血干细胞移植患者51例,Fenwal CS-3000Plus组27例,平均年龄（34.2±10.6）岁;Amicus组24例,平均年龄（35.4±12.1）岁。比较两组采集物有核细胞数、CD34＋细胞数、采集效率、红细胞与血小板采集量及造血重建时间。结果与结论：两组采集物的有核细胞数、CD34＋细胞数、采集效率、红细胞采集量及造血重建时间差异均无显著性意义;Fenwal CS-3000Plus组血小板采集量明显高于Amicus组（P〈0.01）。结果显示Fenwal CS-3000Plus与Amicus血细胞分离机在分离外周血干/祖细胞方面和移植效果没有差异;血小板较低被采集者使用Amicus血细胞分离机采集可能更为安全。     

两种血细胞分离机干/祖细胞采集效果及供者采集前后血液指标变化的比较

目的比较Fenwal CS-3000 Plus(以下简名称Fenwal)与Amicus 2种血细胞分离机分离外周血造血干/祖细胞的效果及干/祖细胞采集后供者血液指标的变化。方法共有56名供者入组,Fenwal组32名,年龄(36.2±11.6)岁,选择单个核细胞采集程序,共循环37次;Amicus组24名,年龄(35.4±12.1)岁,选择MNC采集程序共循环27次。比较2组采集物白细胞总数、单个核细胞百分率、CD34+细胞数及采集前后供者Hct、Plt的变化。结果2组采集物的白细胞数、单个核细胞百分率、CD34+细胞数、采集效率均差异无统计学意义;2组采集后供者Plt下降率Fenwal组供者较Amicus组高;2组采集后供者Hct下降率差异无统计学意义;2组采集物中MNC、CD34+细胞数均与外周血中MNC呈正相关,CD34+细胞百分率与外周血MNC无相关性。结论在分离外周血干/祖细胞方面Fenwal与Amicus没有明显差异。     

3种血细胞分离机采集外周血造血干细胞的安全性与有效性研究

目的 初步探讨3种血细胞分离机在采集外周血造血干细胞中的应用,并分析影响其安全性与有效性的相关因素.方法 总结2005年10月～2012年1月,浙江省血液中心与浙江大学附属第一医院自/异体外周血造血干细胞采集129例,比较并探讨CS-3000 Plus、COM.TEC与COBE Spectra MNC3种血细胞分离机的采集效率与影响因素,评估3种仪器对供者血小板与血红蛋白的影响.结果 129例供者中,CS-3000 Plus血细胞分离机采集47例,共70次;COM.TEC血细胞分离机采集22例,共33次;COBE Spectra MNC血细胞分离机采集60例,共89次.每位供者平均采集1.5次.3种仪器采集的产品CD34+细胞总数无显著性差异,COBE Spectra MNC组体外总循环量与采集产品容量最低,对供者的血小板影响程度最低(P ＜0.005);COM.TEC组对供者血红蛋白的影响最小(P ＜0.005);采集产品中CD34+细胞总数与采集前供者MNC计数和处理血量均呈正相关关系(r =0.771 4,0.397 1,P＜0.001).结论 根据不同供者的循环血量、动员情况、血色素、血细胞计数、患者经济状况等因素选择合适的单采仪器与方法,经过1～2次的单采都可以安全地采集到高浓度的、能满足临床需要的外周血造血干细胞.相比之下,COM.TEC血细胞分离机采集外周血造血干细胞产品容量大,对供者血小板影响也大.     

Cobe Spectra血细胞分离机采集干细胞的效果观察

目的 探讨Cobe Spectra血细胞分离机MNG程序采集外周血干细胞的效果.方法 用Cobe Spectra血细胞分离机的MNC程序采集健康供者和肿瘤患者外周血干细胞;供者给予G-CSF动员,患者采用化疗加G-CSF动员,采集的干细胞用流式细胞仪检测CD34+抗原表达细胞数.供/患者10人次共采集15次,处理抗凝全血(11420±2401)ml,时间(236±28)min,抗凝剂(975±195)ml.结果 采集CD34+细胞(218.14±243.53)x106,MNC的采集效率为(51.02±29.85)%,单采后供/患者Plt、HB、Hct分别下降15.38%、11.22%、11.37%;在整个采集过程中未观察到严重的副反应.结论 Cobe Spectra 血细胞分离机的MNC程序能采集到血小板含量低,高产量有效的自体/异体CD34+细胞.     

不同血细胞分离机采集程序对健康供者造血干细胞采集物细胞成分的影响

目的:观察COBE Spectra血细胞分离机AutoPBSC程序以及Spectra Optia血细胞分离机MNC程序对采集的健康供者外周血造血干细胞成分的影响。方法:2015年1月至2016年8月期间对12例供者随机应用COBE Spectra血细胞分离机AutoPBSC程序以及Spectra Optia血细胞分离机MNC程序进行外周血造血干细胞采集,观察应用不同采集程序获得的采集物中单个核细胞、CD34~+细胞、粒细胞、淋巴细胞、血小板数的差异。结果:两种采集程序在循环血量、采集时间及抗凝剂使用量方面无显著差异。COBE Spectra血细胞分离机AutoPBSC程序采集的采集物体积及单个核细胞计数均低于Spectra Optia血细胞分离机MNC程序的采集物体积及单个核细胞计数。AutoPBSC程序采集的CD34~+细胞计数高于MNC程序采集的CD34~+细胞计数。AutoPBSC程序采集物中混入的淋巴细胞及血小板较MNC程序中多,其差异均有统计学意义(P0.05)。结论:与Spectra Optia血细胞分离机MNC程序相比,COBE Spectra血细胞分离机AutoPBSC程序采集的造血干细胞数量多,混入的淋巴细胞及血小板多。     

幼儿外周血造血干／祖细胞采集方法的建立

本研究探索采集体重低于20kg幼儿外周血造血干／祖细胞的方法及安全性。在采集外周血造血干／祖细胞时，在患儿股静脉处放置7F双腔导管作为采血及回输通道，采用COBE Spectra血细胞分离机的自动干／祖细胞采集程序及管路，在预冲管路完成后，向管路中灌注体外辐照的异体悬浮红细胞，采集后仅回输管路中的红细胞成分。对采集物计数单个核细胞、CD34^＋细胞和细胞存活率。结果表明：对7例低体重幼儿采集外周血造血干／祖细胞13次均获得成功。获得单个核细胞平均数为4．44×10^8／kg[（3．46—6．45）×10^8／kg]，CD34^＋细胞平均计数为2．20×10^6／kg[（1．34—3．79）×10^6／kg]，细胞存活率98．45％（97％-100％）。在采集过程中患儿生命体征平稳。结论：采用COBE Spectra血细胞分离机，可以在保持低体重幼儿生命体征平稳的前提下获得含有足够数量CD34^＋的单个核细胞。     

Amicus与CS-3000血细胞分离机采集外周血造血干细胞效果比较

目的 探讨Amicus与CS-3000血细胞分离机采集外周血造血干细胞的效果.方法 供者均给予G-CSF动员,分别采用Amicus血细胞分离机的MNC程序和CS-3000血细胞分离机的单个核细胞程序采集供者外周血干细胞;用流式细胞仪检测所采集干细胞的CD34+细胞数.供者52例,共采集62次,其中Amicus血细胞分离...     

幼儿外周血造血干/祖细胞采集得率影响因素分析

目的考察利用COBE Spectra血细胞分离机采集幼儿外周血造血干/祖细胞的影响因素。方法根据患儿体重(≤15 kg,>15 kg)、采集时外周血白细胞计数(≤5×109/L,>5×109/L)、淋巴细胞+单核细胞比例(≤18%,>18%)、Hct(≤25%,>25%)、采血速度(≤20 mL/min,>20 mL/min)血细胞分离机报警次数(≤3次,>3次)分别分组,比较2组患儿的每公斤体重单个核细胞计数、CD34+细胞计数及所占比例。结果淋巴细胞+单核细胞比例>18%组与≤18%组比较,Hct>25%组与≤25%组比较,血细胞分离机报警次数≤3次组与>3次组比较,在每公斤体重单个核细胞计数、CD34+细胞计数及所占比例均有显著差异(P<0.01)。其余组别之间差异不显著(P>0.05)。结论采用COBE Spectra血细胞分离机采集幼儿外周血造血干/祖细胞时,淋巴细胞+单核细胞比例、患儿红细胞比积及血细胞分离机报警次数是影响采集得率的因素。     

血细胞分离机不同采集程序对外周血造血干细胞分离效果的影响

目的:观察COBE Spectra血细胞分离机Auto PBSC程序、MNC程序及Spectra Optia血细胞分离机MNC程序采集自体外周血造血干细胞的效果及不良反应。方法:对41例采集对象分别采用COBE Spectra血细胞分离机Auto PBSC程序、MNC程序及Spectra Optia血细胞分离机MNC程序进行自体外周血造血干细胞采集,观察3种采集程序采集的MNC及CD34~+细胞数、采集后患者血红蛋白及血小板下降的差异以及3种采集程序采集过程中的不良反应。结果:在全血处理量及采集时间基本相同的情况下,COBE Spectra和Spectra Optia的MNC程序采集的MNC数较COBE Spectra Auto PBSC程序采集的数高,但采集的CD34~+细胞数均低于Auto PBSC程序采集的CD34~+细胞数(P0.05)。COBE Spectra和Spectra Optia的MNC程序采集的终产物体积大于Auto PBSC程序采集的终产物体积。Spectra Optia血细胞分离机MNC程序与COBE Spectra血细胞分离机MNC程序相比,采集的M NC数无显著差异,但Spectra Optia血细胞分离机M NC程序采集的CD34~+细胞数大于COBE Spectra血细胞分离机MNC程序采集的CD34~+细胞数(P0.05)。Spectra Optia的MNC程序采集后患者血小板及血红蛋白较采集前下降幅度最低(P0.05)。3种程序采集过程中的不良反应相似,患者均可耐受。结论:COBE Spectra血细胞分离机Auto PBSC程序和Spectra Optia血细胞分离机MNC程序采集自体外周血造血干细胞优于COBE Spectra血细胞分离机的MNC程序。Spectra Optia的MNC程序采集后患者血小板及血红蛋白损失最低。     

两种血细胞分离机分离外周血造血干细胞效果比较

目的　比较FenwalCS 3000plus及CobeSpectra两种血细胞分离机分离外周血造血干细胞的效果。方 法　共有76名供者入组。FenwalCS 3000plus组31例,平均年龄(39.1±12.9)岁,共循环38次;CobeSpectra组 45例,平均年龄(38.2±11.2)岁,共循环65次。比较两组采集物白细胞总数、单核细胞百分率、采集物单核细胞中 CD34+细胞百分率。结果　两组采集物的白细胞计数无明显统计学差异;FenwalCS 3000plus组单核细胞百分率 高于CobeSpectra组。两组采集物中CD34+细胞百分率无明显统计学差异。CobeSpectra组采集物中单核细胞百 分率与白细胞数负相关。两组单核细胞百分率、两组白细胞数均与CD34细胞百分率无相关性。结论　本组资料 显示在分离外周血干细胞方面FenwalCS 3000plus与CobeSpectra之间没有差异。     

应用血细胞分离机采集ABO血型不合供者的外周血干细胞

为了探索应用血细胞分离机采集ABO血型主要和(或)次要不合的供者外周血造血干细胞的得率及不去除红细胞或血浆用于干细胞移植的可行性,采用CobeSpectra(Version6.1)血细胞分离机的自动干细胞采集程序对9例异基因外周血造血干细胞供者进行采集,其中ABO血型主要不合4例,次要不合2例,主要次要均不合3例。对ABO血型主要不合及主要、次要均不合的供者每循环收集的细胞成分和血浆的量分别作相应调整。输注前从产品袋中留取标本检查有核细胞计数、单个核细胞比例、CD34 细胞计数和细胞的成活率(台盼蓝拒染率)。输入时对受者采取一系列保护肾功能的措施。液体总量控制在4000毫升/日。结果显示:除1例因供者体重远大于受者经1次采集即可满足移植所需细胞量外,其余供者均经2次采集收集到足够的有核细胞直接回输给受者或冰冻保存备用。共采集PBSC17次,平均每次获得有核细胞3.77×1010个,单个核细胞占97%-99%。CD34 细胞数平均为8.62×106/kg,细胞拒染率均为100%。ABO血型主要不合及主要、次要均不合的供者每次采集的PBSC产品中含压积红细胞8-10ml,ABO血型次要不合供者每次采集的PBSC产品中含血浆80-120ml,不去除红细胞及血浆,直接回输给受者。无1例出现溶血性输血反应,造血功能均获得重建。结论:采用CobeSpectra血细     

Blood component collection by apheresis

Apheresis component collection is a rapidly growing area in the blood collection field. Several instruments with varying capabilities are available. This is a brief review of the equipment available for granulocyte and apheresis component collection and indications for their use. In the United States, granulocytes are collected with the Fenwal CS3000, Fenwal CS3000 Plus, COBE (Gambro) Spectra, Haemonetics LN9000, and Fresenius AS 104. The use of hetastarch for sedimenting agent and stimulation with G-CSF and G-CSF plus dexamethasone have substantially increased granulocyte yields. Plateletapheresis is performed in the United States on the Fenwal CS3000, Fenwal CS3000 Plus, Fenwal Amicus, COBE (Gambro) Spectra, Gambro Trima Version 4, Gambro Trima Accel (Version 5), and Haemonetics LN9000. Automated red blood cell (RBC) collections are performed with the Haemonetics MCS+LN8150, Gambro Trima Version 4, Gambro Trima Accel (Version 5), Amicus, and Baxter Alyx. The RBC can be collected concurrently (with other components) in some instruments or separately in others. Plasma is collected concurrently on several instruments. Plasmapheresis for plasma only is performed on the Fenwal Autopheresis C and Haemonetics PCS2. Granulocyte yields range from 0.46 x 10(10) to 1.0 x 10(10) for unstimulated donors and 2.1 x 10(10) to 2.6 x 10(10) for donors stimulated with dexamethasone or prednisone. The use of G-CSF and G-CSF with dexamethasone has substantially increased granulocyte yields with yields of 4.1 x 10(10) to 10.8 x 10(10) reported. Platelet collection rates of 0.045-0.115 x 10(11) plt/min have been reported. Collection efficiencies of 46-85.7% have been reported. Automated (apheresis) component collection has the advantages of controlled volumes or doses of component, efficient use of the donor, multiple components from the same donor, better inventory control, and better quality control due to less manipulation of the individual components. Disadvantages of automated component collection include the use of expensive equipment and disposables, the need for specially trained machine operators, and lower capacity to collect large volumes of blood compared to whole blood donation. The use of apheresis component collection is rapidly growing to provide the best blood components in the most efficient manner.     

Peripheral blood stem cell collection in a patient with chronic myelogenous leukemia and a high circulating nucleated red cell fraction

A high level of circulating nucleated red blood cells (NRBC) in patients with chronic myeloproliferative syndromes could potentially complicate peripheral blood stem cell (PSC) collection. The mononuclear NRBC might comprise a significant fraction of the total mononuclear cells in the final product. We report a successful PSC collection in a patient with more NRBC than WBC in the peripheral blood. A 27-year-old man with chronic myelogenous leukemia underwent eight PSC collection procedures, seven using the Cobe Spectra (Spectra) and one using the Fenwal CS3000 Plus (CS). PSC product manipulations to remove NRBC were unnecessary. As assessed by post-collection NRBC:WBC ratio as a percent of the initial ratio, Spectra selectively harvested mononuclear leukocytes over NRBC. The collected products had a mean NRBC:WBC ratio that was 3.4% of the peripheral blood ratio. Adequate numbers of mononuclear leukocytes were collected with less than 6% NRBC contamination. The single CS procedure resulted in a comparable NRBC reduction efficiency as the Spectra. We conclude that PSC harvest using automated blood cell separators from patients with a high level of circulating NRBC may result in a product with an acceptable number of NRBC.     

Concurrent comparison of the Cobe Spectra and Fenwal CS3000 for the collection of peripheral blood mononuclear cells for autologous peripheral stem cell transplantation.

Hematopoietic stem cells, collected by leukapheresis from peripheral blood, can be used as an alternative to autologous bone marrow transplantation following high-dose chemotherapy as treatment of several malignancies. We compared the ability of the Cobe Spectra and the Fenwal CS3000 to collect peripheral blood mononuclear cells (MNC) for autologous peripheral blood stem cell transplantation. Ten patients experienced repeated leukapheresis (10 L blood processed per procedure) using both instruments. Procedures were alternated between the two until a total of 7 x 10(8) MNC/kg was collected. Data from 61 Spectra and 50 CS3000 collections were analyzed. The yield (mean per procedure) of nucleated cells (NC) and MNC was higher (P less than .005) with the Spectra (0.77 x 10(10) NC and 0.54 x 10(10) MNC) than with the CS3000 (0.59 x 10(10) NC and 0.40 x 10(10) MNC). However, colony forming units (CFU-GM) were not different (P greater than .05) for Spectra (0.92 x 10(4)) and Fenwal (0.65 x 10(4) collections. Platelet contamination was lower (P less than .001) with the Spectra (2.2 x 10(11)) than the CS3000 (5.0 x 10(11)). This correlated with a higher patient blood platelet count immediately following Spectra collections (117 x 10(9)/L) versus the CS3000 (86 x 10(9)/L). Using the methods described, the Spectra product contained greater yields of NC and MNC with less platelet contamination than did the CS3000.     

Collection efficiencies of MNC subpopulations during autologous CD34+ peripheral blood progenitor cell (PBPC) harvests in small children and adolescents

There is increasing demand for mononuclear cell (MNC) harvests not only for PBPC but also for immune therapies using dendritic cells and donor lymphocytes. We determined the collection efficiencies (CE) of various MNC subpopulations during CD34+ cell harvests using a Fenwal CS 3000 Plus Omnix system in small children and adolescents. The cell content of 140 leukapheresis products (LP) was prospectively evaluated in 45 pretreated patients with solid tumors and hematological malignancies. The median age was 12 years (range 0.8-22), and the median body weight (BW) 43 kg (range 9-92). Depending upon the BW of the patients, the media used for priming were saline (SP) in 86, human albumin (HA, HAP) in 10, and packed red blood cells (BP) in 44 apheresis procedures. The major nucleated cell (NC) fractions collected were monocytes (52% of NC) and CD3+ T cells (26%). The median cell yield for monocytes was 174 * 10(6)/kg (range 24-613) representing a CE of 55%. The median number of CD3(+) T cells was 84 * 10(6)/kg (range 5.6-380; CE = 74%). CD34+ cells represented a very small cell fraction of the LP (1.3% of NC), with a median yield of 4.2 * 10(6)/kg (range 0.2-87) and a CE of 63%. The cell yield of various MNCs was significantly correlated with the cell count in the peripheral blood (PB) and with the blood volume processed (ANOVA, P < 0.0001). No influence on the CE was observed for the priming procedure, the patients' age or sex, or the other adaptations used in the harvesting protocol. In conclusion, the Fenwal CS 3000 Plus OMNIX system with the CD34+ cell program and the described adaptations, is also predictably useful for harvest of monocytes or lymphocytes in pediatric patients. We present regression equations that predict the cell yield of various MNC subpopulations in apheresis products.     

外周血造血干/祖细胞动员与采集时动态快速监测造血祖细胞的意义

为了获得高效的外周血干/祖细胞采集,探索一种简便、快速的外周血干/祖细胞监测方法，采用Sysmex XE-2100血细胞分析仪的幼稚细胞信号（IMI）检测通道识别和计数外周血造血祖细胞（HPC）。对25例行异基因外周血造血干细胞移植动员的供和11例自体外周血干细胞动员的患的外周血造血干/祖细胞进行了动态观察。于动员过程中取外周血进行HPC，CD34^ 细胞和CFU-GM的检测，对采集物也进行上述检测。结果表明：在外周血标本中HPC与CD34^ 细胞和CFU-GM二间均呈良好的正相关性。所有检测病例外周血CD34^ 细胞与HPC同时上升，同时达高峰。供的峰值出现在动员的第5天，快速升高晚于白细胞。而患外周血干/祖细胞的快速升高早于白细胞。采集物中HPC与CD34^ 细胞和CFU-GM呈正相关性。采集当日外周血中HPC和CD34^ 细胞计数与采集所得CD34^ 细胞数量亦具有良好的线性相关。结论：造血祖细胞的监测是一种快速、简便又经济的监测外周血干细胞采集时机和预测成功采集的可靠指标。     

Comparison of two blood cell separators in collecting peripheral blood stem cell components

To ensure that a sufficient number of CD34+ cells are collected for an allogeneic blood progenitor cell transplant, the most effective blood cell separator should be used to collect peripheral blood stem cell (PBSC) components. We compared the effectiveness of two blood cell separators. We gave 29 healthy people 7.5 or 10 μg kg^?1 of granulocyte colony stimulating factor (G-CSF) daily for 5 days and collected one PBSC component with either a Fenwal CS3000 (n = 15) or a Cobe Spectra (n = 14) blood cell separator. The volume of blood processed was the same for each machine (8.4 ± 1.0 L; range = 4.9–9.4 L for the CS3000 and 8.9 ± 1.0 L; range 6.7–10.9 L; P = 0.71). The components collected with the CS3000 contained more mononuclear cells (39.6 ± 21.9 × 10⁹ compared with 26.9 ± 5.6 × 10⁹, P = 0.02) and fewer neutrophils (1.38 ± 1.88 × 10⁹ compared with 5.53 ± 8.71 × 10⁹, = 0.001). The total number of CD34+ cells collected with the two instruments was the same (470 ± 353 × 10⁶ for the CS3000 and 419 ± 351 × 10⁶ for the Spectra; P = 0.64) as was the number of CD34+ cells collected per litre of whole blood processed (55.9 ± 42.0 × 10⁶ L^?1 compared with 45.9 ± 37.9 × 10⁶ L^?1; P = 0.59). The mononuclear cell collection efficiency was greater for the CS3000 (82.4 ± 54.9% compared with 53.3 ± 14.1; P = 0.04) but the CD34+ cell collection efficiencies were the same (87.4 ± 61.1% for the CS3000 compared with 56.3 ± 23.5% for the Spectra; P = 0.07). In conclusion, both blood cell separators collected components which contained large numbers of CD34+ cells, but those collected with the CS3000 contained fewer neutrophils and the CS3000 was more efficient at collecting mononuclear cells.