HX-97方案对外周血造血干细胞动员、采集和移植后造血重建的作用  

Effects of Protocol HX-97 on Mobilization,Collection and Hematopoietic Reconstitution of Peripheral Blood Stem Cells Transplantation

作　　者：刘霆[1] 贾永前[1] 卢忠平 秦莉[1] 徐才刚[1] 吴谨绪[1] 邓长安[1] 

机构地区：[1]华西医科大学附属第一医院血液科,成都610041

出　　处：《华西医科大学学报》1999年第4期428-430,共3页Journal of West China University of Medical Sciences

摘　　要：为提高外周血造血干细胞动员、采集、和移植后造血重建的效率，作者从１９９７ 年４ 月至１９９９ 年６月，进行了２２ 例异基因或自体外周血造血干细胞移植，对外周血造血干细胞动员、采集和移植后造血重建方案（ＨＸ－９７ 方案）作了系统观察。ＨＸ－９７方案的主要内容是：①外周血造血干细胞动员，采用ｒｈＧ－ＣＳＦ３００μｇ／天，皮下注射，共６ 天，第６ 剂在干细胞采集前９０分钟用； ②自体外周血造血干细胞动员采用大剂量化疗加造血刺激因子，化疗强度务必使外周血ＷＢＣ计数＜ １．０×１０９ ／Ｌ，待外周血ＷＢＣ计数从最低点刚显示回升时，开始使用ｒｈＧ－ＣＳＦ；③移植后恢复造血序贯使用ｒｈＧＭ－ＣＳＦ和ｒｈＧ－ＣＳＦ。造血干细胞动员后用ＣＯＢＥＳｐｅｃｔｒａ 血细胞分离机连续采集外周血单个核细胞。结果：２２ 例移植中１６ 例一次采集即成功，６ 例作了第二次采集。按受者体重计，采集后计数ＭＮＣ细胞数２．５～１０．７×１０８／ｋｇ；ＣＤ３４＋ 细胞２．５～２０．０×１０６／ｋｇ；ＣＤ３４＋ ＣＤ３３－ 早期造血干细胞１．８～７．５×１０６／ｋｇ；ＣＤ３４＋ ＣＤ３３＋ 晚期造血祖细胞０．７～１２．５×１０６ ／ｋｇ；ＣＦＵ－ＧＭ 集落３．５～６．In order to enhance the effects of peripheral blood stem cell mobilization,collection and hematopoietic reconstitution, we observed and evaluated the effects of Protocol HX 97 on 22 patients who received allogeneic or autologous peripheral blood stem cell transplants from April 1997 to June 1999. rhG CSF was used for mobilization at a dose of 300μg/day for 6 days; the sixth dose was given an hour and a half before leukapheresis. High dose chemotherapy and rhG CSF were given for autologous peripheral blood stem cell mobilization; the chemotherapy should be intensive enough to reduce the patients′ peripheral WBC to less than 1 0×10 9/L, and the beginning of using rhG CSF should be just at the time of WBC′s rising from the nadir. rhGM CSF and rhG CSF were given sequentially for hematopoietic reconstitution after transplantation. The results showed that leukaphereses were successfully performed for peripheral blood stem cell collection. Sixteen cases needed apheresis only once, and 6 cases needed it twice. The harvests were 2.5 10.7×10 8/kg MNC, 2.5 20.0×10 6/kg CD34 + cells (including 1.8 7.5×10 6/kg CD34 +CD33 -,0.7 12.5×10 6/kg CD34 +CD33 +),and 3.5 6.3×10 5/kg CFU GM. Hematopoietic function recovered to > 0.5×10 9 L of neutrophil count in allo PBSCT at 14 20 days and in auto PBSCT at 12 20 days, and to > 20×10 9/L of platelet count in allo PBSCT and in auto PBSCT at 16 34 days and 16 28 days, respectively. At day +30 post transplantation, chromosome analysis and DNA finger print assessment of bone marrow cells indicated that the patients′ hematopoietic function had been reconstituted. This study suggests that Protocol HX 97 is an effective approach to mobilization of peripheral blood stem cell transplantation, and it is relatively cost effective.

关 键 词：外周血 造血干细胞移植 动员方案 采集 造血重建 

分 类 号：R457.9[医药卫生—治疗学]