自体外周血干细胞动员及采集效果影响因素分析  

Analysis of factors influencing the mobilization and collection of autologous peripheral blood stem cells

作　　者：赵志强[1] 王列样[1] 刘小兰[2] 王江涛[2] 关涛[2] 张宗[2] 罗艳虹[3] 苏丽萍[1] Zhao Zhiqiang;Wang Lieyang;Liu Xiaolan;Wang Jiangtao;Guan Tao;Zhang Zong;Luo Yanhong;Su Liping(Department of Hematology, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China;Department of Hematology Laboratory, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China;Department of Health Statistics, Shanxi Medical University, Taiyuan 030001, China)

机构地区：[1]山西省肿瘤医院血液科,太原030013 [2]山西省肿瘤医院血液科实验室,太原030013 [3]山西医科大学统计学教研室,太原030001

出　　处：《白血病．淋巴瘤》2019年第9期533-537,共5页Journal of Leukemia & Lymphoma

基　　金：山西省科技攻关项目(20140313011-9).

摘　　要：目的探讨自体外周血干细胞动员、采集效果的影响因素。方法收集2012年4月至2017年3月在山西省肿瘤医院行自体外周血造血干细胞动员、采集的62例患者临床资料。分析患者年龄、性别、疾病类型、化疗周期、疾病状态、不同方案和患者采集前1天外周血CD34+细胞对CD34+细胞数和CD34+细胞采集成功率的影响。计量资料比较采用单因素方差分析和t检验;计数资料比较采用χ2检验或Fisher确切概率法;多因素分析采用多重线性回归分析。结果化疗>6个周期与≤6个周期患者间采集物中CD34+细胞数差异有统计学意义[(2.6±1.3)×106/kg比(5.8±2.2)×106/kg;t=5.221,P<0.01],CD34+细胞采集成功率差异有统计学意义[68.8%(11/16)比97.8%(45/46);χ2=8.396,P=0.004];男性患者与女性患者相比,采集物中CD34+细胞数差异无统计学意义[(5.4±2.2)×106/kg比(4.5±2.8)×106/kg;t=1.302,P=0.198],但男性采集成功率高于女性[97.6%(40/41)比76.2%(16/21)],差异有统计意义(χ2=5.017,P=0.025);采集前1天外周血CD34+细胞数≥10个/μl患者采集成功率高于<10个/μl患者[97.9%(47/48)比64.3%(9/14)],差异有统计学意义(χ2=10.668,P=0.001);而不同年龄、疾病类型、疾病状态及不同动员方案的采集物中CD34+细胞数及采集成功率差异均无统计学意义(均P>0.05)。对上述有统计学意义的影响因素进行多因素分析显示,动员前化疗≤6个周期是干细胞采集的有利因素(b=-3.435,P<0.01)。结论自体外周血干细胞的有效动员、采集效果与动员前接受的化疗周期数有关,化疗应尽量≤6个周期,达部分缓解及以上时尽早行干细胞动员、采集,并在动员过程中监测外周血CD34+细胞数。在外周血CD34+细胞数>10个/μl时于次日开始采集可能会获得较好的采集效果,从而提高采集成功率。Objective To explore the factors influencing the mobilization and collection of autologous peripheral blood stem cells. Methods The clinical data of 62 patients who received autologous peripheral blood hematopoietic stem cell mobilization in Shanxi Provincial Cancer Hospital from April 2012 to March 2017 were collected. The effects of age, gender, disease type, chemotherapy cycle, disease status, different schemes and the number of CD34+ cells in peripheral blood of patients 1 d before collection on the number of CD34+ cells and the success rate of CD34+ cells collection were analyzed. Measurement data were compared by one-way ANOVA and t test;count data were compared by χ 2 test;multivariate analysis was performed by multiple linear regression analysis. Results There were statistically significant differences in the number of CD34+ cells between patients with chemotherapy >6 cycles and ≤6 cycles [(2.6±1.3)×106/kg vs.(5.8±2.2)×106/kg;t = 5.221, P < 0.01], and the difference in the success rate of CD34+ cell collection between the two groups was statistically significant [68.8%(11/16) vs. 97.8%(45/46);χ2 = 8.396, P = 0.004]. The difference in the CD34+ cells yield was not statistical significance between male and female patients [(5.4±2.2)×106/kg vs.(4.5±2.8)×106/kg;t = 1.302, P = 0.198)], but the collection success rate in males was higher than that in females [97.6%(40/41) vs. 76.2%(16/21)], and the difference was statistically significant (χ 2 = 5.017, P = 0.025). The success rate of CD34+ cell collection in patients with ≥10/μl CD34+ cell in the peripheral blood was significantly higher than that in patients with < 10/μl CD34+ cells 1 d before the collection[97.9%(47/48) vs. 64.3%(9/14)], and the difference was statistically significant (χ 2 = 10.668, P = 0.001). The differences in CD34+ cells yield and collection success rate between patients with different age, disease type, disease status and mobilization regimen were not statistically significant (all P > 0.05). Multi-factor analysis show

关 键 词：造血干细胞动员 外周血干细胞移植 移植 自体 

分 类 号：R457.7[医药卫生—治疗学] R733[医药卫生—临床医学]