纯化供者CD34^＋细胞输注治疗单倍型造血干细胞移植后移植物功能不良12例临床分析  

Effects of CD34^＋ selected stem cells for the treatment of poor graft function after allogeneic stem celltransplantation

作　　者：费新红[1] 贺俊宝 程昊钰[1] 殷宇明[1] 张维婕[1] 张书芹[1] 王筱璨 王静波[1] Fei Xinhong, He Junbao, Cheng Haoyu, Yin Yuming, Zhang Weijie, Zhang Shuqin, WangXiaocan, Wang Jingbo.(Aerospace Center Hospital of Peking University, Beijing 100049, China)

机构地区：[1]航天中心医院血液科,北京100049

出　　处：《中华血液学杂志》2018年第10期828-832,共5页Chinese Journal of Hematology

摘　　要：目的观察输注纯化供者CD34＋细胞治疗单倍型造血干细胞移植后移植物功能不良的疗效和安全性。方法对2014年1月至2018年3月期间接受供者纯化CD34＋细胞治疗的12例单倍型造血干细胞移植后移植物功能不良患者进行回顾性分析。结果12例患者中男9例、女3例，中位年龄26（14-54）岁；急性淋巴细胞白血病4例，急性髓系白血病5例，慢性髓性白血病2例，慢性粒一单核细胞白血病1例。分选产物CD34＋细胞纯度为92．0％（44．0％-97．00％），回收率为55．0％（45．0％-96．7％），回输CD34＋细胞的中位数为1．9（0．9-4．4）×106／kg，CD3＋细胞中位数为0．6（0．3-2．0）×104／kg。中性粒细胞恢复中位时间为18（14-39）d，血小板恢复中位时间为29（16-153）d，红细胞恢复中位时间为60（9-124）d。12例患者输注过程中未发生严重不良反应，10例获得完全缓解，1例患者获得部分缓解，1例患者无效，未发生重症感染和重度GVHD。结论回输供者纯化CD34＋细胞是单倍型造血干细胞移植后植入功能不良的一种安全、有效治疗方法。Objective To evaluate the efficacy and safety of purified CD34＋ stem cell boost in the treatment of poor graft function （PGF） after allogeneic hematopoietic stem cell transplantation （HSCT）. Methods 12 patients with poor graft function, reported in our hospital during January 2014 to March 2018, were retrospectively analyzed; The donors of 12 patients were HLA mismatched family members, and all treated with donor purified CD34＋ stem cell after G-CSF mobilization, calculating and statistical analyzing the purity of separation and the recovery rate of CD34＋ stem cells. The related complications and the recovery of blood cells after infusion were observed. Results The purity of CD34 ＋ cells in the separation products was 92.0% （44.0%-97.0%）, and the recovery rate was 55.0% （45.0%-96.7%）. The median number of CD34＋ cells was 1.9 （0.9-4.4）x 106/kg with CD3＋ cells as 0.6 （0.3-2.0）x 104/kg. The median durations of white blood cells, platelet and red blood cells recoveries were 18 （14-39）, 29 （16-153 ） and 60 （9-124） days, respectively. All 12 patients didn＇t experience serious adverse reactions in the process of infusion, 10 patients achieved hematopoietic recovery, 1 case partial remission, 1 case no recovery, without occurrence of aggravated infection, graft versus host disease and other complications. Conclusion The infusion of donor purified CD34 ＋ stem cell was a safe and effective method for PGF after allogeneic HSCT.

关 键 词：CD34^+细胞 移植物功能不良 异基因造血干细胞移植 移植物抗宿主病 

分 类 号：R457.7[医药卫生—治疗学]