非霍奇金淋巴瘤患者行外周血单个核细胞采集前后血细胞的变化及影响因素分析

Analysis of the Changes and Influencing Factors of Blood Cells before and after the Collection of Mononuclear Cells in Patients with Non-Hodgkin's Lymphoma

目的探索拟行CAR-T治疗的非霍奇金淋巴瘤患者以及健康供者使用血细胞分离机采集单个核细胞后血细胞的变化,探讨影响终产品单个核细胞数量的因素以更好的提高采集效率。方法使用COM.TEC血细胞分离机采集23例非霍奇金淋巴瘤患者以及22例健康供者的单个核细胞,分别于采集前,采集后即刻抽取血样,检测红细胞(RBC)、白细胞(WBC)、淋巴细胞(lymphocyte cell)、单核细胞(mononuclear cell)、血小板(PLT)计数,分析采集前后血细胞变化情况。同时将年龄、身高、体重、身体质量指数(BMI)、采集时间、白膜泵出量、单次收集量、循环次数、单次循环量、总循环量等与终产品单个核细胞计数(MNC)进行多元线性回归分析。结果健康供者及非霍奇金淋巴瘤患者采集单个核细胞后,血细胞计数较采集前有所下降(P均<0.05);多元线性回归分析显示采集前MNC、单次收集量以及循环次数与终产品MNC密切相关(P均<0.05);而年龄、身高、体重、BMI、全身循环血量、流速与终产品MNC无明显相关性(P均>0.05)。结论为保障患者及供者的健康水平,针对不同的被采集者应制定个体化的采集方案;单次收集量、循环次数以及采集前单个核细胞计数是影响单个核细胞采集效率的主要因素。

Objective To improve collecting efficiency,we investigated the changes of blood cells and influencing factors of collecting mononuclear cells from peripheral blood before CAR-T treatment.Methods MNC cells were collected from 23 Non Hodgkin's lymphoma patients and 22 healthy donors by using COM.TEC blood cell separator.Routine blood test was performed before and after MNC collection,including red blood cell(RBC),white blood cell(WBC),lymphocyte cell,mononuclear cell and platelet count.The changes of blood cells before and after collection were analyzed.At the same time,the age,height,weight,body mass index(BMI),collection time,white membrane pumping volume,single collection volume,circulation times,single circulation volume,total circulation volume and the final product mononuclear cell count(MNC)were analyzed by multiple linear regression.Results The blood cell count of healthy donors and non-Hodgkin's lymphoma patients decreased after MNC collection(all P<0.05);Multiple linear regression analysis showed that the pre-collection MNC,single collection volume and cycle times were closely related to the final product MNC(all P<0.05).However,age,height,weight,BMI,systemic circulation blood volume,and flow rate,had no significant correlation with the final product MNC(all P>0.05).Conclusions In order to ensure the health level of patients and healthy donors,we should make individual collection plan for different recipients.The volume of single collection,the number of cycles and the count of pre-collection monocytes cells are the main factors for the efficiency of MNC collection.