异基因造血干细胞移植中回输造血干细胞的量和回输时受者白细胞数与疾病预后关系分析  

Relation of Reinfused Hematopoietic Stem Cell Volume and Recipient's Leukocyte Count at Reinfusion with Prognosis of Disease in Allo-Hematopoietic Stem Cell Transplantation

作　　者：王晓宁[1] 张梅[1] 贺鹏程[1] 刘心[1] 习杰英[1] 王梦昌[1] 陈丽梅[1] 李静[1] 刘华胜[1] 张海涛[1] 郭彩利[1] 孙春红[1] 

机构地区：[1]西安交通大学医学院第一附属医院血液科,陕西西安710061

出　　处：《中国实验血液学杂志》2013年第6期1530-1534,共5页Journal of Experimental Hematology

摘　　要：本研究旨在探讨异基因造血干细胞移植中造血干细胞的回输量和回输时受者白细胞数与疾病预后关系。回顾性分析西安交通大学医学院第一附属医院血液科收治的37例异基因造血干细胞移植患者的临床资料,按照回输时受者白细胞数分为粒细胞缺乏组和非粒细胞缺乏组,比较两组患者移植后造血重建、移植物抗宿主病(GVHD)、移植后复发及死亡的发生情况;按照回输的单个核细胞数(MNC)及CD34阳性细胞数的中位数,将患者分为高剂量组和低剂量组,比较不同剂量组患者移植后造血重建、GVHD、移植后复发及死亡的发生情况。结果表明,回输时受者为非粒细胞缺乏者造血重建快于粒细胞缺乏者;高剂量MNC组造血重建快于低剂量MNC组;CD34阳性细胞计数高剂量组与低剂量组之间造血重建无统计学显著差异。高剂量MNC组和非粒细胞缺乏组GVHD发生率高(P<0.05)。不同回输造血干细胞量及回输时白细胞数组间复发及死亡率间无统计学显著差异。结论:异基因造血干细胞移植中MNC计数和回输时受者白细胞数与造血重建相关;高剂量MNC组和非粒细胞缺乏组GVHD发生率高;回输造血干细胞的量与回输时受者白细胞数与疾病的复发及死亡无显著关系。This study was aimed to investigate the relation of reinfused hematopoietic stem cell volume and recipint＇s leukocyte count at reinfusion with prognosis of disease in allo-hematopoietic stem cell transplantation （allo-HSCT）. The clinical data of 37 patients received allo-HSCT in our hospital were analyzed retrospectively. The 37 patients were divided into agranulocytosis and non-agranulocytosis groups according to the recipient＇s leukocyte count at reinfusion, and were divided into the high dose and low dose groups according to the median number of reinfused monomeclear cells （MNC） and CD34＋ cells. Then, hematopoietic reconstructions, GVHD, relapse and death rates of patients were compared. The results showed that the hematopoietic reconstruction of patients in non-agranulocytosis group and high dose MNC group were earlier than that in agranulocytosis group and low dose MNC group. There was no significant difference of hematopoietic reconstruction between the groups of high dose CD34＋ cells and low dose CD34＋cells. The GVHD incidence was higher in high dgse MNC group and non-agranucocylosis group than that in low dose MNC group and agranulocytosis group （ P 〈 0.05 ）. There were no statistical differences of relapsed and death rates between different reinfused number of HSC and recipient＇s leukocyte count at reinfusion. It is concluded that the infused MNC number and the recipient＇s leukocyte count at reinfusion in allo-HSCT correlated with hematopoietic reconstruction, the GVHD incidence is high in high dose MNC and non-agranulocytosis groups, the reinfused HSC volume and the recipient＇s leukocyte count at reinfusion not significantly relate with relapse and death rates.

关 键 词：异基因造血干细胞移植 单个核细胞计数 造血重建 移植物抗宿主病 

分 类 号：R457.7[医药卫生—治疗学]