肿瘤细胞生物治疗中单个核细胞采集的影响因素分析

目的:探讨在肿瘤细胞生物治疗单个核细胞采集中,影响终产品单个核细胞计数(mononuclear cell,MNC)和采集效率(collection efficiency,CE)的因素。方法:对共计142例肿瘤患者和健康供者的采集数据进行分析,包括年龄、性别、身高、体重、身体质量指数(body mass index,BMI)、全身血容量、诊断类别、血管通路、操作者、终产品量、ACD抗凝剂用量、流速、循环次数、采前血红蛋白(Hb)、红细胞计数(RBC)、血小板计数(Plt)、白细胞计数(WBC)、淋巴细胞计数、单核细胞计数、中性粒细胞计数、去掉抗凝剂的循环血量、终产品单个核细胞计数和单个核细胞的采集效率。其中单个核细胞CE(%)=终产品MNC×100/(采前MNC×去掉抗凝剂的循环血量)。采用T检验和多元线性回归分析研究影响终产品MNC和CE的因素。结果:肿瘤患者的CE高于健康供者(24.41±1.91,20.01±0.99,P=0.043),不同操作者之间CE不同(P=0.01,H=18.59)。终产品MNC与终产品容量、ACD抗凝剂用量、采前淋巴细胞计数呈正相关(P=0.00,P=0.01,P=0.00,r=0.811);MNC的CE与流速、采前RBC计数呈负相关,与操作者工作年限、ACD抗凝剂用量呈正相关(P=0.01,P=0.04,P=0.03,P=0.00,r=0.495)。结论:采前淋巴细胞计数越高、ACD抗凝剂用量和终产品容量越多,终产品MNC越多;ACD抗凝剂用量越多,操作者资历越高单个核细胞CE越高;采前RBC越高、采集流速越快,单个核细胞CE越低。

Factors Influencing Mononuclear Cell Collection in Tumor Cell Biotherapy

Objective:To investigate the factors affecting counting and collection efficiency of the final productmononuclear cells(MNCs)in the collection of mononuclear cells for tumor cell biotherapy.Methods:The collected data of 142 tumor patients and healthy donors were analyzed,including age,sex,height,weight,BMI,the total blood volume,diagnostic category,vascular access,operator,final product volume,ACD anticoagulant usage,flow rate and circulation times,pre-apheresis Hb,RBC,Plt,WBC,lymphocyte count,monocyte count,neutrophil count,circulating blood volume without anticoagulant,final product MNC and collection efficiency of MNC.CE(collection efficiency)%=final product MNC×100/(pre-apheresis MNC×circulating blood volume without anticoagulant).The factors affecting final products MNC and CE of MNC were detected by T test and multiple linear regression analysis.Results:The CE of tumor patients was higher than that of healthy donors(24.41±1.91,v s 20.01±0.99),(P=0.043),and CE of MNC was different among different operators(P=0.01,H=18.59).There was a positive correlation of the final MNC with the volume of final product,ACD anticoagulant usage and pre-apheresis lymphocyte count(P=0.00,P=0.01,P=0.00,r=0.811);CE of MNC negatively correlated with flow rate and pre-apheresis RBC,but positively correlated with operator’s working age and ACD anticoagulant usage(P=0.01,P=0.04,P=0.03,P=0.00,r=0.495).Conclusion:more higher pre-apheresis lymphocyte,more amount of the final product and ACD anticoagulant usage,and more high the final MNC.During the collecting process,more ACD anticoagulant usage and more high operator’s seniority,lead to the higher MNC’S CE;while more high pre-apheresis RBC and more fast flow rate,cause the lower the CE of MNC.