单采粒细胞的采集和输注疗效分析  

Apheresis granulocyte collection and transfusion efficacy

作　　者：刘丽萍 杨俊龙 胡燕 何霞 张利 杨丽娟 彭涛 LIU Liping;YANG Junlong;HU Yan;HE Xia;ZHANG Li;YANG Lijuan;PENG Tao(Department of Blood Transfusion,The General Hospital of Western Theater Command,Chengdu 610083,China)

机构地区：[1]解放军西部战区总医院输血科,四川成都610083

出　　处：《中国输血杂志》2022年第5期528-531,共4页Chinese Journal of Blood Transfusion

摘　　要：目的 分析献血者经G-CSF动员后采集单采粒细胞的安全性和患者输注单采粒细胞的疗效。方法 收集本院献血者经G-CSF动员后采集单采粒细胞前后的血常规、采集过程数据、献血者随访情况分析单采粒细胞采集的安全性,收集患者输注单采粒细胞前后的血常规、临床症状改善及治疗结局分析单采粒细胞输注的疗效。结果 27名献血者共捐献29U单采粒细胞,采集时间(229±20)min,循环血量(9 890±1 107)mL,抗凝剂用量(1 002±97)mL,有2名献血者发生献血不良反应,经处理后完成单采粒细胞采集。献血者经G-CSF动员后血常规WBC升高(5.61±1.06)×10^(9)/L vs(22.85±5.23)×10^(9)/L,RBC、Hb、Hct、Plt变化不明显,献血后1~2 d血常规恢复至G-CSF动员前水平,献血1周后的随访无身体不适情况发生。4名抗生素治疗无效的粒细胞缺乏合并多重耐药菌感染的患者输注29U单采粒细胞,输注过程顺利无不良反应发生,输注前后血常规变化不明显,但患者感染症状改善明显(通过临床表现、细菌培养结果、体温监测、CT检查等判断),单采粒细胞输注后评价均为有效。4名患者中1人治愈出院,1人放弃治疗,1人因败血症死亡,1人因多器官脏器功能衰竭死亡。结论 献血者经G-CSF动员后用血细胞分离机采集单采粒细胞是安全的,单采粒细胞产品基本达到国家质量要求,满足患者治疗需求,对粒细胞缺乏合并难治性多重耐药的细菌或真菌感染患者,持续高剂量单采粒细胞输注对控制感染是有效的。Objective To analyze the safety of apheresis granulocyte(AG) collection from blood donors mobilized by G-CSF and apheresis granulocyte transfusion efficacy in patients.Methods The blood routine results, collection process and follow-up of blood donors mobilized by G-CSF before and after AG collection were collected to analyze the safety of AG collection, and the blood routine results, clinical symptom improvement and treatment outcome of patients before and after AG transfusion were collected to analyze the transfusion efficacy.Results A total of 27 blood donors donated 29 U AG,with collection time at(229±20)min, circulating blood volume at(9 890±1 107)mL,and the dosage of anticoagulant at(1 002±97)mL.Two blood donors had adverse reactions to blood donation, and the AG collection was carried out after treatment.After G-CSF mobilization, WBC increased significantly from(5.61±1.06) ×10^(9)/L to(22.85±5.23) ×10^(9)/L,while RBC,Hb, Hct and Plt showed no significant change.The blood routine returned to the level before G-CSF mobilization 1-2 days after blood donation.No physical discomfort occurred during the one week after blood donation.Four patients with granulocyte deficiency complicated with multidrug-resistant bacterial infection, who failed to respond to antibiotic treatment, were transfused with 29 U AG,with no adverse reactions and no obvious change in blood routine, but the infection symptoms were improved significantly judged from clinical manifestation, bacterial culture results, temperature monitoring and CT examination, suggesting that the AG infusion was effective.Among the 4 patients, 1 was cured and discharged, 1 gave up treatment, 1 died of sepsis, and 1 died of multiple organ failure.Conclusion It is safe to collect AG from blood donors mobilized by G-CSF through blood cell separator, and the AG products basically meet the national quality requirements and the treatment needs.Sustained high-dose AG transfusion has a significant effect on infection control in patients with agranulocytosis comb

关 键 词：单采粒细胞 G-CSF动员 输血 血细胞计数 粒细胞缺乏 

分 类 号：R457.12[医药卫生—治疗学] R557.3[医药卫生—临床医学]