研究概要
CAR-T 采集过程中的 CE2 强烈受采集前血液学参数影响,尤其是 WBC。
中文摘要
背景与目的
嵌合抗原受体(CAR)T细胞疗法需通过白细胞单采收集自体T细胞。虽然已有多种因素被认为会影响最佳单采效果,但目前尚无共识。采集效率是该过程的核心指标,但可靠的预测因素尚未确定。本研究旨在识别采集效率(CE2)的预测因子,以支持标准化的单采优化方案。
方法
我们回顾性分析了2022年8月至2025年6月期间,韩国峨山医疗中心为tisagenlecleucel(Kymriah)制备所进行的单采操作及相关数据。数据包括患者诊断、单采前外周血和采集袋样本的实验室结果及操作参数。采用Pearson相关、广义线性模型、单变量逻辑回归和逐步多变量逻辑回归识别CE2预测因素。
结果
75名成人患者共进行了82次单采(中位年龄60.5岁,范围19–86岁),多数诊断为弥漫性大B细胞淋巴瘤(n=71)。平均处理血量为12.2 L,相当于总血容量的3.1倍。平均CE2为68.9%(范围10.6–150.4)。CE2与白细胞计数(WBC)、CD3计数、总血容量校正的CD3计数(TBV CD3)和淋巴细胞计数的对数转换值均呈显著负相关。单变量回归中,对数转换WBC、中性粒细胞计数、TBV CD3和CD3计数均与较高CE2负相关。多变量分析显示,对数转换WBC与高CE2的可能性降低独立相关,与其和低CE的关系一致(OR=0.416,P=0.0339)。
结论
CAR-T 单采期间的CE2受单采前血液学参数显著影响,尤其是WBC。建立CE2预测因子有助于优化处理血量估算,并改善开展CAR-T 制备中心的计划安排。
展开英文摘要原文
METHODS
We retrospectively analyzed apheresis procedures and related data for Tisagenlecleucel (Kymriah) manufacturing between August 2022 and June 2025 at Asan Medical Center. Data included patients' diagnoses, laboratory results of pre-apheresis peripheral blood sample and collection bag sample, and procedural parameters. Pearson correlation, generalized linear model, univariate logistic regression, and stepwise multivariate logistic regression and were performed to identify CE2 predictors.
RESULTS
Eighty-two apheresis procedures were performed in 75 adult patients (median age, 60.5 years; range, 19-86). Most were diagnosed with diffuse large B-cell lymphoma (n = 71). Mean processed blood volume was 12.2 L, equivalent to 3.1 times total blood volume. Mean CE2 was 68.9% (range, 10.6-150.4). CE2 showed significant negative correlations with log-transformed white blood cell count (WBC), CD3 count, total blood volume (TBV) CD3, and lymphocyte count. In univariate regression, log-transformed WBC, neutrophil count, TBV CD3, and CD3 count were inversely associated with high CE2. In multivariate analysis, log-transformed WBC was independently associated with decreased odds of high CE2, consistent with association with low CE. (OR = 0.416, p = 0.0339).
CONCLUSIONS
CE2 during CAR-T apheresis is strongly influenced by pre-apheresis hematologic parameters, particularly WBC. Establishing CE2 predictors may refine estimation of processing volumes and improve planning for centers initiating CAR-T manufacturing.
论文信息
- 作者
- Kim HJ、Lim JM、Ryu K、Hwang SH、Oh HB、Ko DH
- 第一作者单位
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.South Korea
- 通讯作者单位
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: daehyuni1118@gmail.com.South Korea
- 期刊
- Cytotherapy2026 Mar