ABO血型不合供者外周血造血干细胞的采集及移植效果研究  

Peripheral blood stem cell collection for ABO incompatible allogeneic donors and the effectiveness of transplantation

作　　者：叶书来[1] 应美爱[1] 陈家萍[1] 刘会兰[2] 

机构地区：[1]安徽省立医院输血科,安徽合肥230001 [2]安徽省立医院血液科,安徽合肥230001

出　　处：《中国输血杂志》2009年第7期542-546,共5页Chinese Journal of Blood Transfusion

摘　　要：目的探讨应用CS-3000 Plus血细胞分离机采集ABO血型不合供者外周血造血干细胞的效率及不去除红细胞和/或血浆进行异基因外周血造血干细胞移植(PBSCT)的安全性。方法经G-CSF 5μg/(kg.d)动员的异基因外周血干细胞供者33名,应用CS-3000 Plus血细胞分离机的干细胞采集程序于动员后d 5采集,其中ABO血型主要不合12名,次要不合8名以及ABO血型相合13名。根据供者外周血的红细胞压积(Hct)和单个核细胞(MNC)计数,对分离机参数作相应调整。输注前从产品袋中留取干细胞,检测有核细胞数、MNC比例、CD34+细胞数、红细胞、血浆含量。单次处理循环血量(9 986±2 489)ml,抗凝剂用量(971±162)ml。供者采集前注射10%葡萄糖酸钙,以预防低钙反应。观察PBSC输注后受者的生命体征、尿液颜色及是否有溶血相关不良反应等。结果ABO血型主要不合组、次要不合组与ABO血型相合组采集物中的有核细胞数、CD34+细胞数、MNC比例无统计学差异(P>0.05),3组供者每次采集的PBSC产品终体积近60 ml,ABO主要不合组采集物中混入红细胞为(3.67—10.25)×1010/袋,ABO次要不合组采集物中血浆量为22—38 ml,不去除红细胞及血浆,直接回输给受者,均未出现溶血反应,所有患者造血功能均获得重建。结论应用CS-3000 Plus血细胞分离机采集ABO血型不合供者的外周血干细胞,通过调整分离机参数,减少ABO血型不合红细胞的混入,可以获得足够的干细胞数量并安全用于移植。Objective To evaluate the yield of the CS-3000 Plus blood cell separator for collection of peripheral blood stem ceils （PBSC） from ABO incompatible allogeneic stem cell donors and the feasibility of PBSC component infusion to the recipients without the removal of erythrocytes or plasma. Methods Peripheral blood hematopoietic stem cells were collected by CS-3000 Plus blood cell separator with auto-peripheral blood stem cell program from 33 allogeneic donors. All of 33 donors were given hypodermic granulocyte colony-stimulating factor （G-CSF） 5μg/kg per day for mobilization. Of all donors,12 were ABO major incompatible,8 were minor incompatible, and 13 were ABO identical. The amount of PBSC component was harvested, and the parameter was modified according to the hematocrit and mononuclear cell （MNC） counts of donors. The nucleated cell count, percentage of MNC, number of CD34^＋ cells and number of erythrccytes, volume of plasma were measured before infusion. The mean circulation volume was 9986 ml, and the mean volume of anticoagulant infused was 971 ml. In order to prevent such adverse effects as hypocalcemia,10% calcium gluconate was given intravenously before conection. Vital signs ,color of the urine and other hemolysis related adverse effects were observed after each infusion. Results The nucleated cell count, percentage of MNC, number of CD34^＋ cell showed no significant difference between ABO-incompatible group and ABO-compatible group（ P 〉 0. 05 ）. The volumes of PBSC collected each time in the 3 groups were about 60 ml,and there were （3.67--10. 25）×10^10 erythrocytes per pack in the ABO major incompatible group, and 22--38 ml of plasma in ABO minor incompatible component. All the PBSC were infused to recipients without the removal of erythrocytes or plasma, and no haemolytic reaction was observed in any recipients and all their hematopoietic functions were re-establisbed. Conclusion Enough PBSC can be harvested by using CS-3000 Plus blood cell separator from ABO incompatible all

关 键 词：ABO血型不合 异基因外周血干细胞 血细胞分离机 溶血 

分 类 号：R457.1[医药卫生—治疗学]