CAR-T（CAR-T）细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T（CAR-T）细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
在儿科细胞治疗采集过程中减少异体血液暴露：一种保守的预充策略
英文原题：Reducing allogenic blood exposure in paediatric cellular therapy collections: A conservative prime strategy.
查看英文原题
Reducing allogenic blood exposure in paediatric cellular therapy collections: A conservative prime strategy.
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研究概要
未致敏的 MNC 采集在儿科患者中可安全进行，即使 ECV/TBV 比值超过 15%。通过仔细监测和程序规划，这种保守策略可能减少同种异体血液暴露，而不影响安全性或采集效率。
研究思路结论见上方概要
背景
单核细胞（MNC）采集对于接受CAR-T 细胞和造血干细胞移植等细胞疗法的儿科患者至关重要。在儿童中，体外循环血量（ECV）常超过总血容量（TBV）的15%，传统上需要红细胞（RBC）预充以降低血流动力学不稳定的风险。然而，RBC预充会引入异体血液暴露及相关并发症。本研究评估了在ECV/TBV比值大于15%的儿科患者中进行无预充MNC采集的安全性和可行性。
方法
我们回顾性分析了2例接受Spectra Optia系统连续单个核细胞采集模式进行MNC采集的B细胞急性淋巴细胞白血病（B-ALL）儿科患者。两例患者的ECV/TBV比值分别为16%和17%。在整个操作过程中及操作后监测生命体征和实验室参数，以评估不良事件、血流动力学不稳定及输血需求。
结果
两名患者均完成了MNC采集，无不良反应、中断或生命体征的临床显著变化。术后血红蛋白和血小板计数未见大幅下降，两名患者均无需输血。采集效率符合机构标准，未观察到低血容量或枸橼酸盐中毒症状。
展开英文摘要原文
MATERIALS AND METHODS
We retrospectively reviewed two paediatric patients with B-cell acute lymphoblastic leukaemia (B-ALL) who underwent MNC collection using the Spectra Optia system in continuous mononuclear cell collection mode. Both patients had ECV/TBV ratios of 16% and 17%, respectively. Vital signs and laboratory parameters were monitored throughout and after the procedures to assess for adverse events, haemodynamic instability, and need for transfusion.
RESULTS
Both patients completed MNC collection without adverse reactions, interruptions, or clinically significant changes in vital signs. Post-procedural haemoglobin and platelet counts showed no major declines, and neither patient required transfusion. Collection efficiency met institutional standards, and no symptoms of hypovolemia or citrate toxicity were observed.
CONCLUSION
Unprimed MNC collection can be safely performed in paediatric patients even when the ECV/TBV ratio exceeds 15%. With careful monitoring and procedural planning, this conservative strategy may reduce allogenic blood exposure without compromising safety or collection efficiency.
论文信息
- 作者
- Pavlovich A、Akgun Y
- 单位
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, California, Los Angeles, USA.United States
- 文献类型
- 病例报告
- 期刊
- Transfusion medicine (Oxford, England)2025 Jun
- 原文标识
- PubMed 40387228 · DOI 10.1111/tme.13151