Extracorporeal photopheresis in paediatric patients: A retrospective comparison between different 'off-line' protocols.

Autor: Sebastián E; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.; Fundación Investigación Biomédica Hospital Infantil Niño Jesús (FIBHINJ), Madrid, Spain., Andrés Esteban EM; Fundación Investigación Biomédica Hospital Infantil Niño Jesús (FIBHINJ), Madrid, Spain.; Applied Economics Department, Universidad Rey Juan Carlos, Madrid, Spain., González-Vicent M; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., González de Pablo J; Fundación Investigación Biomédica Hospital Infantil Niño Jesús (FIBHINJ), Madrid, Spain., Zubicaray J; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.; Fundación Investigación Biomédica Hospital Infantil Niño Jesús (FIBHINJ), Madrid, Spain., Gálvez E; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Guillén M; Hematology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain., Ruiz Pato J; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Molina B; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Albi G; Radiology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Ramírez M; Hematology and Oncology Laboratory, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Castillo A; Hematology and Oncology Laboratory, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Pérez Maroto F; Hematology and Oncology Laboratory, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Madero L; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Díaz MÁ; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain., Sevilla J; Onco-Hematology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.; Fundación Investigación Biomédica Hospital Infantil Niño Jesús (FIBHINJ), Madrid, Spain.
Jazyk: angličtina
Zdroj: Vox sanguinis [Vox Sang] 2022 Oct; Vol. 117 (10), pp. 1220-1229. Date of Electronic Publication: 2022 Sep 14.
DOI: 10.1111/vox.13346
Abstrakt: Background and Objectives: Extracorporeal photopheresis (ECP) has been shown to be an effective treatment for graft-versus-host disease (GvHD). However, information regarding lymphocyte collection for ECP in children is limited. The aim of this study was to analyse and compare lymphocyte collection for ECP in children using different devices and protocols. Moreover, we have studied both safety and variables of the infused product related to treatment efficacy.
Patients and Methods: This was a retrospective study of 91 patients who underwent 1524 apheresis procedures with either the COBE Spectra or Spectra Optia system. The comparison study between the Optia protocols (MNC and CMNC) was prioritized. We analysed 578 procedures using the Optia blood cell separator: 204 and 374 using the MNC and the CMNC protocol, respectively.
Results: The Optia CMNC protocol showed better collection efficiency, with increased lymphocyte collection per kg of body weight (p < 0.001). On multivariate analysis, the type of protocol showed no relationship with haematocrit or platelet loss. Most procedures were well-tolerated, with the most frequent adverse events related to venous access (21.7%). Seventy-one percent of patients had either partial or complete clinical GvHD response. In the multivariate model, only two variables were associated with a better response to ECP, younger age and a greater increase of B lymphocytes after treatment.
Conclusion: Lymphocyte collection for ECP is well-tolerated in most children, achieving complete or partial response in more than half of GvHD patients. CMNC is the optimal software to perform lymphocyte collection in children.
(© 2022 International Society of Blood Transfusion.)
Databáze: MEDLINE
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