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    袁玖莲, 王海洋, 刘灿侠, 闫志凌, 韩雪, 冯媛媛. CAR-T前体细胞采集前后血液成分变化及临床分析[J]. 徐州医科大学学报, 2024, 44(6): 461-465. DOI: 10.3969/j.issn.2096-3882.2024.06.012
    引用本文: 袁玖莲, 王海洋, 刘灿侠, 闫志凌, 韩雪, 冯媛媛. CAR-T前体细胞采集前后血液成分变化及临床分析[J]. 徐州医科大学学报, 2024, 44(6): 461-465. DOI: 10.3969/j.issn.2096-3882.2024.06.012
    YUAN Jiulian, WANG Haiyang, LIU Canxia, YAN Zhiling, HAN Xue, FENG Yuanyuan. Changes in blood composition and clinical analysis before and after CAR-T precursor cell collection[J]. Journal of Xuzhou Medical University, 2024, 44(6): 461-465. DOI: 10.3969/j.issn.2096-3882.2024.06.012
    Citation: YUAN Jiulian, WANG Haiyang, LIU Canxia, YAN Zhiling, HAN Xue, FENG Yuanyuan. Changes in blood composition and clinical analysis before and after CAR-T precursor cell collection[J]. Journal of Xuzhou Medical University, 2024, 44(6): 461-465. DOI: 10.3969/j.issn.2096-3882.2024.06.012

    CAR-T前体细胞采集前后血液成分变化及临床分析

    Changes in blood composition and clinical analysis before and after CAR-T precursor cell collection

    • 摘要: 目的 分析患者嵌合抗原受体T细胞(CAR-T)前体细胞采集前后血液成分变化,为CAR-T前体细胞采集工作提供借鉴。方法 选取2022年1月—2023年12月徐州医科大学附属医院血液科应用COM.TEC型血细胞分离机收集CAR-T前体细胞的129例患者作为研究对象,回顾性分析相关资料。观察采集前后白细胞(WBC)计数、淋巴细胞计数、红细胞(RBC)计数、血红蛋白(Hb)、血细胞比容(HCT)、血小板(PLT)计数及电解质Ca2+、K+、Na+、Cl-变化差异。记录采集过程的不良反应,分析血液成分变化的原因。将性别、年龄、体重、疾病类型以及采集前WBC计数、淋巴细胞计数、PLT计数、HCT与终产品单个核细胞(MNC)计数进行多元线性回归分析。结果 129例患者CAR-T前体细胞均采集成功,MNC计数均值为7.4×109/L(1.4×109/L~38.0×109/L),无重度单采不良事件发生。采集后淋巴细胞计数、RBC计数、Hb、HCT及PLT计数较采集前显著下降(P<0.05),WBC计数较采集前上升,但差异无统计学意义(P>0.05);K+、Cl-浓度显著下降(P<0.05),Ca2+、Na+浓度较采集前差异无统计学意义(P>0.05)。多元线性回归分析显示,采集前WBC计数、淋巴细胞计数、HCT及体重与终产品MNC计数密切相关(P<0.05)。结论 通过COM.TEC型血细胞分离机采集患者CAR-T前体细胞安全可行。采集前保持较高的WBC计数、淋巴细胞计数、HCT及适当的体重可有效提高采集效果。

       

      Abstract: Objective To analyze the changes in blood composition before and after collection of chimeric antigen receptor T-cell (CAR-T) precursor cells from patients, in order to provide reference for CAR-T precursor cell collection. Methods A total of 129 patients, who underwent CAR-T precursor cell collection by COM.TEC-type blood cell separator in Department of Hematology in the Affiliated Hospital of Xuzhou Medical University from January 2022 to December 2023 were selected as research subjects for retrospective analysis. The white blood cell (WBC) count, lymphocyte count, red blood cell (RBC) count, hemoglobin (Hb), hematocrit (HCT), and platelet (PLT) count before and after collection, and the changes in electrolytes, such as Ca2+, K+, Na+, and Cl-, were observed, while adverse reactions during collection were recorded, and the reasons for changes in blood composition were analyzed. Then, gender, age, body weight, disease types and pre-collection WBC count, lymphocyte count, PLT count, HCT and end-product mononulear cell (MNC) count were analyzed by multiple linear regression. Results CAR-T precursor cells were successfully collected in all 129 patients, and the mean MNC count was 7.4×109/L (1.4×109/L-38.0×109/L), without severe single-collection adverse events. Lymphocyte count, RBC count, Hb, HCT and PLT count significantly decreased after collection, compared with those before collection (P<0.05), while WBC count increased withont statistical differences (P>0.05). Furthermore, K+ and Cl- concentrations significantly decreased (P<0.05), and the differences in Ca2+ and Na+ concentrations were not statistically significant (P>0.05). Multivariate linear regression analysis showed that pre-collection WBC count, lymphocyte count, HCT, and body weight were closely associated with MNC count (P<0.05). Conclusions Collection of CAR-T precursor cells in patients by COM.TEC-type blood cell separator is safe and feasible. Maintaining high WBC count, lymphocyte count, HCT and appropriate body weight before collection can effectively improve collection effect.

       

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