影响恶性肿瘤患者造血系统自体外周血造血干细胞数量和质量的因素分析(英文)  

Effective factors for quantity and quality of auto-peripheral blood stem cells in hematopoietic system of patients with malignant tumor

作　　者：肖扬[1] 蒋祖军[1] 林竞韧[1] 肖浩文[1] 李颂文[1] 肖芷芳[1] 严定安[2] 

机构地区：[1]解放军广州军区广州总医院血液科,广东省广州市510010 [2]南方医科大学珠江医院血液科,广东省广州市510280

出　　处：《中国组织工程研究与临床康复》2007年第20期4052-4056,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:造血系统恶性肿瘤的造血重建除与疾病本身、预处理方案、移植后支持治疗手段等相关外,自体外周血造血干细胞的动员、采集和冻存是影响其移植后造血系统顺利重建的关键因素。目的:观察造血系统恶性肿瘤患者自体外周血造血干细胞经动员、采集和冻存后,重新回输至造血系统的重建情况,并分析影响外周血造血干细胞数量和质量的因素。设计:以造血系统恶性肿瘤为对象的病例分析。单位:解放军广州军区广州总医院血液科,南方医科大学珠江医院血液科。对象:选取2000-02/2004-12解放军广州军区广州总医院血液科收治的18例造血系统恶性肿瘤住院患者,年龄16～56岁,其中急性髓性白血病2例,急性淋巴细胞白血病1例,淋巴瘤白血病2例,慢性粒细胞白血病2例,多发性骨髓瘤4例,非霍奇金淋巴瘤7例。粒细胞集落刺激因子(Granocyte,中外制药产品,批号N3G31)。方法:①全部病例均采用对肿瘤有效的联合化疗方案+粒细胞集落刺激因子进行动员。联合化疗方案:白血病患者第1～3天每隔12h给予阿糖胞苷2g/m2,第1～5天给予足叶乙甙200mg/m2或氟达拉宾50mg/m2。多发性骨髓瘤患者给予阿糖胞苷方案同上,第1～2天给予环磷酰胺1g/m2。淋巴瘤患者第1～2天给予环磷酰胺2g/m2。各类型患者化疗后白细胞降至1.0×109L-1以下时开始进行粒细胞集落刺激因子动员,5μg/(kg.d)皮下注射至采集结束。②当白细胞恢复至(4.0～10.0)×109L-1时开始采集外周血造血干细胞,单个核细胞计数≥4.0×108/kg或CD34+细胞≥2.0×106/kg时结束采集,经程序降温仪处理置入-196℃液氮中保存,37～40℃水浴解冻。③患者病灶部位行局部照射预处理,200cGy/次,5次/周,连续4周,总剂量40Gy。结束后48h回输外周血造血干细胞(55.3±28.7)mL,回输日距采集日平均为(56.5±22.3)d。全部患者于干细胞移植后第1天起皮下注射粒细胞集落刺激�BACKGROUND： Hematopoietic reconstruction of malignant tumor in hematopoietic system is related to disease itself, pretreatment program and therapeutic tool after transplantation; especially, mobilization, collection and cryopreservation of auto-peripheral blood stem cell play a key role in successful reconstruction of hematopoietic system after transplantation. OBJECTIVE： To investigate the reconstruction of hematopoietic system through mobilization, collection and cryopreservation of auto-peripheral blood stem cell in patients with malignant tumor and analyze the effective factors on quantity and quality of auto-peripheral blood stem cell. DESIGN ： Case analysis based on malignant tumor in hematopoietic system SETTING： Department of Blood, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA; Department of Blood, Zhujiang Hospital, Nanfang Medical University. PARTICIPANTS： A total of 18 patients with malignant tumor in hematopoietic system were selected from Department of Blood, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA. Their ages ranged from 16 to 56 years. Among them, 2 patients had acute myelogenous leukemia （AML）, 1 acute lymphoblastic leukemia （ALL）, 2 lymphoblastic leukemia （LL）, 2 chronic granulocytic leukemia （CGL）, 4 multiple myeloma （MM）, and 7 non-Hodgkin lymphoma. Granulocyte colony-stimulating factor （G-CSF） was made by Chugai Pharmaceutical Company Limited （batch number： N3G31 ）. METHODS： （1） All patients were mobilized with associated chemotherapy ＋ G-CSF. Associate chemotherapy： Patients with leukemia were given 2 g/m^2 arabinosyl cytosine every 12 hours from the first to the third days and 200 mg/m^2 etoposide or 50 mg/m^2 fludarabine from the first to the fifth days. In addition, patients with MM were treated with arabinosyl cytosine as the same way mentioned above and with 1 g/m^2 cyclophosphamide from the first to the second days. And patients with lymphoma were given 2 g/m^2 cyclopho

关 键 词：外周血干细胞移植 造血系统 肿瘤 粒细胞集落刺激因子 造血干细胞 

分 类 号：R394.2[医药卫生—医学遗传学]