自体外周血干细胞的动员和采集及其移植效果的研究  

A STUDY ON THE PERIPHERAL BLOOD STEM CELLS MOBILIZATION,COLLECTION AND THEIR EFFECIS ON ENGRAFTMENT

作　　者：王良绪[1] 禹涛[1] 赵昕[1] 尉达民 祝扬 

机构地区：[1]北京医科大学第三医院血液科

出　　处：《中华内科杂志》1995年第10期659-662,共4页Chinese Journal of Internal Medicine

摘　　要：对２２例自体外周血干细胞移植（ＡＰＢＳＣＴ）的三种动员方案、采集方法及移植的外周血干细胞（ＰＢＳＣ）数量与造血重建关系，进行了研究。２２例中急性白血病１１例，多发性骨髓瘤６例，非何杰金淋巴瘤４例，晚期乳癌１例。三组动员方案：化疗十四氢叶酸＋氟美松；化疗＋ｒｈＧＭ－ＣＳＦ（重组人粒巨噬细胞集落刺激因子）＋氟美松；化疗＋ｒｈＧ－ＣＳＦ（重组人粒细胞集落刺激因子）＋氟美松。用流式细胞计双染直接免疫荧光法测定ｒｈＧ－ＣＳＦ方案组中７例ＣＤ３４＋／ＣＤ３３￣＋细胞。结果表明：（１）ｒｈＧ－ＣＳＦ方案组的ＰＢＳＣ产率最高，平均每例ＭＮＣ（单个核细胞）（８．２９±６．１４）×１０￣８／ｋｇ，ＣＦＵ－ＧＭ（粒单系祖细胞集落生成单位）（２１．３５±１７．２４）×１０￣４／ｋｇ。（２）ＣＤ３４＋细胞数与ＭＮＣ及ＣＦＵ－ＧＭ数大致相关。ＣＤ３４￣＋细胞在动员前外周血中多为０或＜０．５％，动员后约在用ｒｈＧ－ＣＳＦ后６～８天明显增多，就可连续每日采集，如达到≥５×１０￣５／ｋｇ即可停止。（３）采集与回输的ＰＢＳＣ数量是决定造血重建的关键。he methods of mobilization and collection of stem cells in peripheral blood stem cells transplantation(PBSCT)and the association between the number of stem cells transplanted and hematopoietic recovery were studied.The investigation was carried in 22 patients(11 acute leukemia,6 multiple myeloma,4 non- Hodgkin’s lymphoma,1 breast cancer).Three regimens for mobilization were carried out as follows :(1)chemotherapy+tetrahydrofolic acid + dexamethasone,(2)chemotherapy + rhGM-CSF + dexamethasone,(3)cbemotherapy + rhG-CSF + dexamethasone,Besides,CD34/CD33 dual-color direct immunofluo- rescence flow cytometry assay was performed in 7 cases in the rhG-CSF group.The results showed:(1)The mean number of collected cells(MNC) in the rhG-CSF group was MNC(8.29±6.14)×10￣8/kg and CFU-GM(21.35±17.24)×10￣4/kg, being highest among the 3 groups. (2)The number of cells cor- related with MNC and CFU-GM. CD34+ cells in the peripheral blood were 0 or<0.5%before mobiliza- tion and increased markedly 6～8 days after rhG-CSF administration,Harvesting should be started at that time and carried out every day until CD34￣+ cells reached 5×10￣6/kg,(3)The number of PBSC transplant- ed was the key to hematopoietic recovery.

关 键 词：白血病 干细胞 自体移植 

分 类 号：R733.710.5[医药卫生—肿瘤] R730.56[医药卫生—临床医学]