ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.1

年代:1995

数据来源: MAL

摘要:

ABSTRACTMobilized peripheral blood is increasingly used as a source of cells to provide hematopoietic reconstitution in marrow ablated patients. There is controversy as to how the engraftment potential of these preparations should be evaluated. The long-term culture-initiating cell is a very primitive hematopoietic with unique phenotypic feature. The potential role and significance of these cells in peripheral blood cell autografts is discussed.

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.3

年代:1995

数据来源: MAL

摘要:

ABSTRACTThe use of peripheral blood progenitor cells (PBPC) for hematopoietic rescue after high-dose chemotherapy is limited by the number of leukaphereses required to collect an adequate number of hematopoietic progenitors. To optimize the collection of PBPC, we evaluated a single large-volume leukapheresis protocol with citrate anticoagulation. A group of 23 patients received cyclophosphamide (4 g/m2) and GM-CSF (5 μg/kg/day for 15 days) as PBPC mobilization, with a single outpatient 6 h leukapheresis performed on the COBE Spectra 15 days later. Citrate (0.190 mmol/ml) was infused at 1.2 ml/L of blood/minute with a whole blood to citrate ratio between 17:1 and 25:1. Calcium chloride (50 mM) was administered at a citrate to calcium molar ratio between 10:1 and 5:1 to prevent hypocalcemia. A median 36.6 L (range 24.4–46.4) blood was processed using 338 mM citrate (269–473) and 50 mM calcium (25–75). A median 5 × 106CD34+cells/kg (<0.3–24) and 6.2 × 105CFU-GM/kg (<0.001–29) were collected, representing 5.6 and 5.9 more PBPC, respectively, than were in circulation at the initiation of leukapheresis. We conclude that a 6 h large-volume leukapheresis following cyclophosphamide and GM-CSF mobilization is safe, can recruit hematopoietic progenitors into the circulatory compartment, and allows the collection of high numbers of PBPC in a sing

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.11

年代:1995

数据来源: MAL

摘要:

ABSTRACTRecently, high-dose chemo- and radiotherapy for newly diagnosed young patients with multiple myeloma has been established in member centers of the Nordic Myeloma Study Group (NMSG). The treatment includes supportive use of autologous hematopoietic blood progenitors harvested by leukapheresis. Safe and adequate hematopoietic support with minimal toxicity requires optimization of the number and quality of harvested progenitors. We have therefore established a workshop consisting of the 11 laboratories within the NMSG with the aim of developing recommendations for enumeration of CD34-positive cells.In this first workshop report, we discuss technical variables affecting the enumeration of progenitors harvested by leukapheresis and make specific recommendations. The products are analyzed within 4 h following erythrocyte lysis using the Ortho lysing solution for 8–10 minutes. A sample containing 0.5−1.0 × 106nucleated cells is incubated with the test or control antibody (anti-CD34 = HPCA-2PE and Ms IgG1PE from Becton Dickinson) at dilutions of 1:10 to 1:40 in a final volume of 1 ml. The samples are incubated 15 minutes at ambient temperature, washed two to three times, and fixed with 1% paraformaldehyde (150 μl/pellet) for a minimum of 10 minutes. Flow cytometric analysis is performed on 50,000 cellular events with debris eliminated. The estimation of CD34-positive cells can be performed on an FL2-side-scatter plot after marking of a positive population containing>50 events. Using quadrant statistics, this population can be identified in the upper left quadrant, among cells with the side-scatter profile of small lymphocytic cells. The negative control must be judged negative by the analyzer and the small number of events subtracted from the positive population.Subsequent calculation of the total number of CD34-positive cells per kg patient weight is based on the CD34 estimate and the total number of nucleated cell harvested. Allowing for variations in estimation of progenitors, a safe progenitor number appears to be>2.0 × 106CD34-positive cells per kg, which can be harvested in two to three leukapheresis procedures.Future workshops will focus on multiparametric evaluation of CD34-positive subsets with an attempt (i) to define megakaryoblast subsets, (2) to optimize quantitative polymerase chain reaction for evaluation of tumor cell contamination, and, finally, (3) to establish recommendations for the leukapheresis procedure

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.21

年代:1995

数据来源: MAL

摘要:

ABSTRACTDifferent procedures for umbilical cord blood (CB) collection, separation, and cryopreservation were compared to evaluate the feasibility of large-scale CB banking for unrelated transplant. CB collection using an open system was associated with a 12.5% rate of bacterial contamination, whereas this rate fell to 3.3% using a closed collection system. When the umbilical cord was clamped within 30 s after delivery, on 378 occasions it was possible to collect 77 ± 23 ml of CB without risk to mother or infant. Considering that engraftment can be obtained in recipients of 20 × 103CFU-GM/kg, 86% and 28% of CB samples with a volume larger than 50 ml were found to contain a sufficient number of CFU-GM to engraft patients of 20 and 70 kg, respectively. Both Ficoll and gelatin purification procedures were associated with a recovery of 86–92% of CFU-GM, BFU-E, CFU-GEMM, and HPP-CFC, but the gelatin method appears to be more suitable for large-scale CB banking in vials. After cryopreservation, the recovery of clonogenic progenitors was similar for both CB samples stored as whole blood or as mononuclear cells separated using Ficoll or gelatin. In conclusion, large-scale CB banking seems feasible, and CB cell separation could allow storage of a large number of CB samples in a limited liquid nitrogen sp

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.29

年代:1995

数据来源: MAL

摘要:

ABSTRACTG-CSF-mobilized peripheral blood progenitor cells (PBPC) were utilized in a patient who failed to engraft after an unmanipulated HLA-matched allogeneic bone marrow transplant. Marrow engraftment occurred after repeated conditioning with high-dose cyclophosphamide and PBPC infusion. Severe graft-versus-host disease (GVHD) developed shortly after marrow engraftment. The role of PBPC in allogeneic transplant, the associated potential risk of GVHD, and the necessity of reconditioning before stem cell reinfusion are discussed.

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.37

年代:1995

数据来源: MAL

摘要:

ABSTRACTHigh-dose chemoradiotherapy in conjunction with autologous bone marrow transplantation has been used in the treatment of advanced stage neuroblastoma. Because of frequent marrow involvement, marrow purging methods, such as the immunomagnetic technique, have been developed. Current cost constraints force institutions to consider in-house purging versus submission of marrow to purging centers. Our analysis demonstrates that 15 procedures per year are needed to justify an up-front investment in equipment and supplies with a break-even period of 5 years. This number is also required to keep technical proficiency current without frequent retraining of personnel. The analysis includes start-up costs for institutions without a bone marrow processing laboratory, as well as for institutions already processing marrow or peripheral blood stem cells. For institutions performing fewer procedures per year, submission of marrow to purging centers is more cost effective than in-house purging.

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.41

年代:1995

数据来源: MAL

摘要:

ABSTRACTThe status of hemopoietic stem cell transplantation in Australia from January 1,1993 to December 31, 1993 is reported. A total of 523 hematopoietic stem cell transplants were carried out throughout Australia during this 12 month period: 296 autologous transplants, 223 allogeneic transplants, and 4 syngeneic transplants. These were carried out by transplant programs in 20 hospitals, and the total number of transplants represented a 9.4% increase on the total number performed in 1992 (n= 478). Of the 296 autologous transplants, 133 utilized blood stem cells only, 125 marrow stem cells only, and 38 both. The most common indications for autologous transplant were non-Hodgkin's lymphoma (n= 92), acute myeloid leukemia (n= 53), breast cancer (n= 37), Hodgkin's disease (n= 33), and myeloma (n= 25). The most common indication for allogeneic transplantation was chronic myeloid leukemia (n= 59), acute myeloid leukemia (n= 56), acute lymphoblastic leukemia (n= 43), and severe aplastic anaemia (n= 14). The number of allogeneic transplants performed for individual diseases was comparable between 1992 and 1993, but increases in the number of autologous transplants for non-Hodgkin's lymphoma (26%), Hodgkin's disease (45%), breast cancer (48%), and myeloma (20%) were seen.

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.45

年代:1995

数据来源: MAL

摘要:

ABSTRACTGraft versus host disease, graft failure, and disease relapse remain significant impediments to successful allogeneic transplantation.Ex vivoengineering of the graft offers the opportunity to modify the cellular composition to overcome these problems. This review describes recent developments that employ this approach.

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.53

年代:1995

数据来源: MAL

ISSN:1061-6128    

DOI:10.1089/scd.1.1995.4.61

年代:1995

数据来源: MAL