多发性骨髓瘤患者高效动员外周血造血干细胞1例报告及文献复习  

High efficiency of peripheral blood hematopoietic stem cell mobilization in multiple myeloma： one case report and literature review

作　　者：李猛[1] 孟涛疆 管立勋[1] 凌宇 王璐[1] 靖彧[1,3] 王书红[1,3] 朱海燕[1,3] 黄文荣[1,3] 

机构地区：[1]解放军总医院海南分院血液科,海南三亚572000 [2]武警三亚疗养院,海南三亚572000 [3]解放军总医院血液科,北京100853

出　　处：《国际输血及血液学杂志》2015年第6期461-465,共5页International Journal of Blood Transfusion and Hematology

基　　金：海南省社会发展科技专项资金项目（SF201306）

摘　　要：目的 探讨多发性骨髓瘤（MM）患者外周血造血干细胞（HSC）动员获得高比例CD34＋细胞的影响因素.方法 选择2014年1月解放军总医院海南分院血液科收治的1例64岁MM患者为研究对象.本例患者连续接受4个疗程硼替佐米＋盐酸多柔比星脂质体＋地塞米松方案诱导治疗达完全缓解后,在硼替佐米＋大剂量环磷酰胺（CTX）＋地塞米松方案联合重组人粒细胞集落刺激因子（rhG-CSF）的基础上,同时联合重组人血小板生成素（rhTPO）进行HSC动员,观察其动员效果,并结合近年相关文献进行分析.结果 HSC采集物中CD34＋细胞比例高达6.80％,单次外周血HSC采集获得单个核细胞含量为3.17＆#215;108/kg,CD34＋细胞含量为19.20义106/kg.患者移植后第10天粒细胞植入,移植后第12天血小板植入.结论 对于MM患者,在联合rhG-CSF化疗基础上,再联合rhTPO进行HSC动员,安全、高效.本研究高效动员外周血HSC仅为个案报告,是否可于MM患者中广泛推广、应用,仍需更多大样本、多中心的随机对照试验进一步证实.Objective To explore the influential factors of obtaining high proportion of CD34＋ cells in patients with multiple myeloma （MM） peripheral blood hematopoietic stem cell （HSC） mobilization.Methods One patient with MM who was 64 years old and hospitalized in Department of Hematology,Hainan Branch of Chinese PLA General Hospital was enrolled into this study on January 2014.The patient achieved complete remission after four courses of bortezomib ＋ doxorubicin hydrochloride liposome ＋ dexamethasone induction regimens.Then peripheral blood HSC was mobilized with bortezomib ＋ high dose cyclophosphamide ＋ dexamethasone regimens in combination with recombinant human granulocyte colony-stimulating factor （rhG-CSF） and recombinant human thrombopoietin （rhTPO）.Mobilization effect was reported with its relevant literature reviewed.Results The proportion of CD34＋ cells in HSC graft was 6.80%.The number of mononuclear cells and CD34＋ cells in harvest of single collection was 3.17 × 108/kg and 19.20× 106/kg,respectively.Engraftment time of neutrophil and platelet was 10 days and 12 days after HSC transplantation,respectively.Conclusions Chemotherapy in combination with rhG-CSF and rhTPO is effective and safety for autologous HSC mobilization in MM patient.As this research is just a case report,it still needs many large sample and multi-center randomized controlled trials to confirm whether it can be widely used in MM patients.

关 键 词：多发性骨髓瘤 造血干细胞移植 造血干细胞动员 

分 类 号：R733.3[医药卫生—肿瘤]