37例CAR-T细胞治疗的白细胞采集效果分析

Factors that influence lymphocyte yields in lymphocytapheresis for chimeric antigen receptor T cells treatment,37 cases report

目的探讨CAR-T细胞治疗前,使用血细胞分离机采集患者与健康供者白细胞的效率与影响因素。方法应用COBE Spectra血细胞分离机AutoPBSC程序进行CAR-T细胞的患者与健康供者白细胞采集。结果采集前后RBC计数[(2.81±0.65 vs 2.75±0.68)×1012/L]、Hct[(25.5±6.62 vs 24.28±6.91)%]无明显变化(P>0.05);采集后Hb下降[(82.77±19.87)g/L vs(76.6±19.42)g/L,P<0.05];Plt显著下降[(147.8±90.41)×109/L vs(111.8±91.28)×109/L,P<0.05];自体CD3+、CD8+显著高于健康供者[(91.9±6.2)%vs(19.1±11.6)%,P<0.01];(50.8±22.4)%vs(26.3±6.8)%,P<0.01];自体白细胞采集效率显著高于健康供者[(36.1±21.1)%vs(19.1±11.6)%,P<0.01]。患者与健康供者CD4+在6%—55%,CD4+/CD8+在0.19—5,CD8+在19%—61.9%,白细胞采集数量均达标,后期CAR-T细胞培养成功。另外,自体CAR-T细胞治疗患者采集白细胞效率与采集前外周血WBC、RBC、Hb、Hct、Plt相关(P<0.05)。健康供者白细胞采集效率与采集前外周血WBC计数相关(P<0.05),与RBC、Hb、Hct、Plt无关(P>0.05)。结论患者白细胞采集效率与外周血WBC、RBC、Hb、Hct、Plt相关且采集效率优于健康供者。

Objective To explore the yields and factors that influence the cell composition of lymphocytapheresis concentrates in patients and healthy donors using blood cell separator,collected for chimeric antigen receptor T(CAR T)cells treatment.Methods The lymphocytapheresis of patients and healthy donors,collected for CAR T cells treatment,was carried out using AutoPBSC protocols recommended by COBE Spectra blood cell separator.Results No significant difference was observed between pre-and post-apheresis RBC counts(×1012/L)(2.81±0.65 vs 2.75±0.68)and Hct level(%)(25.5±6.62 vs 24.28±6.91)(P>0.05).Hb(g/L)(82.77±19.87 vs 76.6±19.42)and Plt(×109/L)(147.8±90.41 vs 111.8±91.28)decreased significantly after apheresis(P<0.05).The composition(%)of autologous CD3+(91.9±6.2 vs 19.1±11.6)and CD8+(50.8±22.4 vs 26.3±6.8)was significantly higher than that of healthy donors(P<0.01).The yield(%)of autologous lymphocyte was significantly higher than that of healthy donors(36.1±21.1 vs 19.1±11.6,P<0.01).The composition(%)of CD4+and CD8+in patients and healthy donors ranged between 6%—55%and 19%—61.9%,with the ratio of CD4+/CD8+between 0.19—5;qualified yields and subsquent CAR modified T cells were obtained.The autologous lymphocyte yields in patients were significantly influenced by pre-apheresis lymphocyte counts,RBC counts,Hb,Hct and Plt(P<0.05).While the yields in healthy donors were significantly influenced by pre-apheresis lymphocyte counts(P<0.05)regardless pre-apheresis RBC counts,Hb,Hct and Plt(P>0.05).Conclusion Better yields were obtained from autologous lymphocytapheresis from patients rather than healthy donors,which would be significantly influenced by pre-apheresis lymphocyte counts,RBC counts,Hb,Hct and Plt.