ABO血型不合的异基因造血干细胞采集及移植效果研究  

Peripheral Blood Stem Cell Collection from ABO Incompatible Allogeneic Donors and Its Effect in Hematopoietic Stem Cell Transplantation

作　　者：许伟[1] 朱梅[2] 李燕萍[1] 卞茂红[1] 卫玉芝[1] 夏雪[1] 张循善[1] 

机构地区：[1]安徽医科大学第一附属医院输血科,安徽合肥230022 [2]合肥市第一人民医院核医学科,安徽合肥230061

出　　处：《中国实验血液学杂志》2011年第5期1237-1240,共4页Journal of Experimental Hematology

摘　　要：本研究评价COBE Spectra血细胞分离机按干细胞采集程序采集HLA配型相合、ABO血型不合供者外周血造血干细胞的效能,观察未去除红细胞和(或)血浆进行异基因外周血干细胞移植的效果。应用COBE Spectra血细胞分离机的自动干细胞采集程序采集28例异基因供者外周血干细胞,并选用同期ABO血型相合15例作对照。检测采集物有核细胞(NC)数、单个核细胞(MNC)比例及CD34+细胞计数,观察造血功能重建情况和转变为供者血型所需要的时间。结果表明,ABO血型不合和相合组采集物中的NC、CD34+细胞数、MNC比例无统计学差异(p>0.05)。ABO血型不合组和相合组中性粒细胞和血小板恢复的时间无统计学差异(p>0.05)。14例ABO血型主要不合患者,红系造血明显延迟,ABO血型不合组28名患者于移植后35-193天血型成功转变为供者型,和ABO血型相合组相比均有统计学差异(p<0.01)。结论:ABO血型不合不是异基因造血干细胞移植的障碍,主要不合可能是红系造血明显延迟的主要原因。The study was aimed to evaluate the yield of the COBE Spectra blood cell separator with auto-peripheral blood stem cell program for collection of peripheral blood hematopoietic stem cells（PBHSC） from HLA-matched ABO-incompatible allogeneic PBHSC donor,and observe the safety and effect of allogeneic peripheral blood hematopoietic stem cell transplantation（allo-PBHSCT） without removal of erythrocytes and plasma.PBHSC from 28 allogeneic donors were collected by COBE Spectra blood cell separator with auto-peripheral blood hematopoiEtic stem cell（auto-PBHSCT） program.Control group included 15 HLA-matched patients who received allo-PBHSCT with ABO-compatible grafts.The amount of PBHSC was harvested and the parameter was modified according to the hematocrit and mononuclear cell（MNC） counts of donors.The nucleated cell count,proportion of MNC,number of CD34＋ cells were detected,and reconstitution status of hematopoietic function and time for change into donor′s blood group were observed.The results showed that the nucleated cell count proportion of MNC and number of CD34＋ cells showed no significant difference between groups of ABO incompatible and compatible（p0.05）.All their hematopoietic functions were reconstituted.Between the ABO incompatibility and the compatible groups,the time of neutrophil and platelet recovery was not significantly different（p0.05）,In ABO blood major incompatible and the compatible groups,the recovery of erythropoiesis were significantly delayed（p0.01）.The blood type of 18 patients in ABO incompatible group was turned into donor′s blood type successfully at 35-139 days after transplantation.It is concluded that major ABO incompatibility did not affect the erythropoiesis reconstitution in HLA matched allo-HSCT.the major incompatibility may be a main reason of erythropoietic delay.

关 键 词：ABO血型不合 ABO血型相合 异基因外周血造血干细胞移植 纯红细胞再生障碍 

分 类 号：R457.7[医药卫生—治疗学]