Stem cell mobilizating effect of heparin in patients undergoing autologous stem cell transplantation

IF 1.4 4区医学 Q4 HEMATOLOGY

Journal of Clinical Apheresis Pub Date : 2023-07-28 DOI:10.1002/jca.22079

Mustafa Merter MD, Ugur Sahin MD, Osman İlhan MD, Meral Beksac MD

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引用次数: 0

Abstract

Background

Adequate stem cell collection is essential for successful stem cell transplantation. Heparin enhances stem cell mobilization by competing with heparin sulfate proteoglycans. Heparin is also used as an anticoagulant before leukapheresis. Here, we evaluated the effects of heparin on stem cell mobilization in patients who underwent autologous stem cell transplantation (ASCT).

Methods

We evaluated patients who underwent ASCT. Patients were divided into two groups: those who received heparin plus citrate (heparinized patients) and those who received citrate only (nonheparinized patients) for anticoagulation. Univariate and multivariate analyses were also performed. The collection efficiency 2 (CE2) for CD34+ cells was calculated and compared between heparinized and nonheparinized patients.

Results

This study included 1017 patients. There were 478 (47%) heparinized and 539 (53%) nonheparinized patients. The number of collected CD34+ cells was significantly higher in heparinized patients (P < .00001). The multivariate analyses showed that using heparin was an independent positive factor for collected CD34+ cells (adj-R² = 0.744; F = 369.331, P < .00001). CE2 was significantly higher in heparinized patients than in nonheparinized patients (66.8% vs 52.1%; P < .00001). The rate of collecting at least 2 × 10⁶/kg CD34+ cells was 3.3 times higher for heparinized patients in poor mobilizers (P < .00001). Heparinized patients had significantly higher total nucleated and mononuclear cell counts (P < .00001 and <.00001, respectively).

Conclusion

Heparin enhances stem cell collection and increases CE2. The use of heparin may reduce the need for other strategies to increase stem cell mobilization.

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肝素对自体干细胞移植患者的干细胞动员作用

充分的干细胞收集是干细胞移植成功的必要条件。肝素通过与硫酸肝素蛋白聚糖竞争增强干细胞动员。肝素也被用作白血病采血前的抗凝剂。在这里，我们评估了肝素对自体干细胞移植(ASCT)患者干细胞动员的影响。方法对行ASCT的患者进行评估。患者被分为两组:接受肝素加柠檬酸盐抗凝治疗的患者(肝素化患者)和仅接受柠檬酸盐抗凝治疗的患者(非肝素化患者)。还进行了单因素和多因素分析。计算并比较肝素化和非肝素化患者CD34+细胞的收集效率2 (CE2)。结果纳入1017例患者。478例(47%)肝素化患者和539例(53%)非肝素化患者。肝素化患者收集到的CD34+细胞数量明显高于肝素化患者(P < .00001)。多因素分析显示，使用肝素是收集到的CD34+细胞的独立阳性因素(j- r2 = 0.744;F = 369.331, P < 0.00001)。肝素化患者的CE2显著高于非肝素化患者(66.8% vs 52.1%;P < .00001)。动员能力差的肝素化患者收集至少2 × 106/kg CD34+细胞的率高出3.3倍(P < 0.00001)。肝素化患者有核细胞总数和单核细胞总数明显增加(P <)。00001和<00001年,分别)。结论肝素可促进干细胞收集，提高CE2水平。肝素的使用可能减少对其他策略增加干细胞动员的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Apheresis 医学-血液学

CiteScore

2.80

自引率

13.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Clinical Apheresis publishes articles dealing with all aspects of hemapheresis. Articles welcomed for review include those reporting basic research and clinical applications of therapeutic plasma exchange, therapeutic cytapheresis, therapeutic absorption, blood component collection and transfusion, donor recruitment and safety, administration of hemapheresis centers, and innovative applications of hemapheresis technology. Experimental studies, clinical trials, case reports, and concise reviews will be welcomed.