米托蒽醌、阿糖胞苷、粒细胞集落刺激因子的动员方案及大容量采集自体外周血干细胞(英文)  

Mobilization of autologous peripheral blood stem cells by mitoxantone,arabinosylcytosin and granulocyte colony-stimulating factor regimen and harvesting by large-volume leukapheresis

作　　者：黄一虹[1] 徐开林[1] 何徐彭[1] 李德鹏 鹿群先[1] 李宝林 嵇月红[1] 孙海英[1] 潘秀英[1] 

机构地区：[1]徐州医学院附属医院血液科,江苏省徐州市221002 [2]徐州市中心血站,江苏省徐州市221002

出　　处：《中国组织工程研究与临床康复》2007年第24期4837-4841,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:外周血干细胞移植成功的首要条件是干细胞的有效动员和采集,选择高效低毒的动员方案,掌握动员和采集时机与动员效果密切相关。目的:探讨米托蒽醌-大剂量阿糖胞苷方案化疗后,单用粒细胞集落刺激因子或粒细胞集落刺激因子与粒-巨噬细胞集落刺激因子合用对恶性血液病和实体瘤患者自体外周血干细胞的动员效果。设计:观察对比实验。单位:徐州医学院附属医院血液科。对象:选择1998-09/2006-12在徐州医学院附属医院血液科收治的42例恶性血液病和实体瘤患者,诊断符合国际白血病分型及世界卫生组织新分类标准。男25例,女17例,年龄7～54岁,平均29岁,体质量(52±18)kg。其中急性髓细胞白血病12例,急性淋巴细胞白血病6例,慢性粒细胞白血病慢性期1例,非霍奇金淋巴瘤15例,霍奇金淋巴瘤4例,多发性骨髓瘤2例,晚期乳癌2例。患者均经常规化疗达到或接近完全缓解,骨髓细胞学检查无肿瘤细胞浸润。心、肺、肝、肾等主要脏器功能正常。动员前化疗疗程平均8次,所有患者均对治疗项目知情同意。方法:患者均采用米托蒽醌10mg/(m2·d)静脉滴注第2～3d后,阿糖胞苷2g/m2静脉滴注第1～2d,1次/12h。当白细胞计数下降至最低点开始回升时,20例患者使用粒细胞集落刺激因子5～7.5μg/(kg·d),连用3～5d,22例患者早6:00给予粒细胞集落刺激因子5～7.5μg/(kg·d),晚6:00给予粒-巨噬细胞集落刺激因子5～7μg/(kg·d)。白细胞计数>2.5×109 L-1,CD34+细胞≥1%时,用CS3000plus血细胞分离机连续2d采集自体外周血干细胞,检测CD34+细胞含量和T淋巴细胞亚群。①单个核细胞与FITC标记的CD34+、CD3和CD8单抗及与CD4PE标记的CD4单抗4℃混合30min,采用流式细胞仪检测CD34+细胞和T细胞亚群,分析5×105个细胞,得出CD3、CD34+细胞含量及CD4/CD8比值。用甲基纤维素法测定粒-巨噬细胞集落形成单位。②观察术后相关不�BACKGROUND： The primary qualification of peripheral blood stem cell transplantation （PBSCT） is the effective mobilization and harvesting of hematopoietic stem cells. The mobilization efficacy is closely related to the selection of high-efficacy low-toxicity regimen, the timing of mobilization and harvesting as well.OBJECTIVE： To investigate the efficacy of mitoxantone （MIT） combined with high-dose arabinosylcytosin （Ara-C）,followed by granulocyte colony-stimulating factor （G-CSF） alone or combination of G-CSF and granulocyte-macrophage colony-stimulating factor （GM-CSF） on mobilizing PBSCs in patients with hematological malignancies and solid tumors.DESIGN： Controlled study with observation.SETTTNG： Department of Hematology, the Affiliated Hospital of Xuzhou Medical College.PARTICIPANTS： Forty-two patients with hematological malignancies and solid tumors admitted to Department of Hematology, Xuzhou Medical College from September 1998 to December 2006 were involved in this study. They were diagnosed according to FAB classification criteria and new WHO proposals. The involved patients, 25 male and 17 female, averaged 29 years ranging from 7 to 54 years and weighted （52±18） kg. Among them, 12 were patients with acute myeloblastic leukemia, 6 were patients with acute lymphoblastic leukemia （ALL）, 1 was patient with chronic granulocytic leukemia （CGL） at chronic phase, 15 were patients with non-Hodgkin lymphoma （NHL）, 4 were patients with Hodgkin lymphoma （HL）, 2 was patient with multiple myeloma （MM）, 2 were patients with advanced breast cancer. All the patients apprcached to or got complete remission after conventional chemotherapy. No tumor cell infiltration was observed in bone marrow cytological examination. The functions of the main organs such as heart, lung, liver and kidney,and so on, were normal. The patients underwent an average of 8-course chemotherapy before the mobilization. Informed consents of all the patients were obtained.METHODS： MIT was intra

关 键 词：外周血干细胞 动员 细胞单采 米托蒽醌 阿糖胞苷 造血生长因子 

分 类 号：R394.2[医药卫生—医学遗传学]