自体外周血造血干细胞动员采集的影响因素  

Factors affecting the mobilization and collection of autologous peripheral blood hematopoietic stem cells

作　　者：陈晓 郭智 陈丽娜 刘玄勇 张弋慧智 李旭绵 王月乔 韦丽娅 谢晶 蔺莉 Chen Xiao;Guo Zhi;Chen Lina;Liu Xuanyong;Zhang Yihuizhi;Li Xumian;Wang Yueqiao;Wei Liya;Xie Jing;Lin Li(Department of Hematology&Oncology,National Cancer Center/National Clinical Research Cancer for Cancer/Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen 518116,Guangdong Province,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院血液肿瘤科,广东省深圳市518116

出　　处：《中国组织工程研究》2021年第19期2958-2962,共5页Chinese Journal of Tissue Engineering Research

基　　金：深圳市卫生系统科研项目(SZLY2018003),项目负责人:郭智;北京白求恩公益基金医学项目(BQE-TY-SSPC1-S-08),项目负责人:郭智。

摘　　要：背景:自体外周血造血干细胞移植因患者年龄范围宽、移植后并发症少、费用低,临床应用日益广泛。移植后造血功能的重建主要取决于输入造血干细胞的数量和质量。文章从临床实际出发,分析影响外周血造血干细胞采集的各种因素,并计算出适宜采集的血常规标准,对提高临床外周血造血干细胞采集成功率进而提高自体移植成功率有重要意义。目的:分析血液肿瘤患者自体外周血造血干细胞动员采集过程中相关因素对CD34^+细胞数的影响。方法:回顾性分析中国医学科学院肿瘤医院深圳医院2018年6月至2020年6月共36例患者自体外周血造血干细胞动员采集过程中各种因素对所采集的CD34^+细胞数的影响,主要包括年龄、性别、体表面积、疾病种类、采集当天各类细胞水平、采集前化疗次数、采集前疾病状态、初诊时有无骨髓受累等因素。结果与结论:①CD34^+细胞数与采集当天白细胞数、单核细胞绝对值、单核细胞比例、淋巴细胞比例有关,差异有显著性意义(均P<0.05);对上述4个指标进一步分析,发现采集当天单核细胞绝对值对CD34^+细胞数的预测价值最高,其次为淋巴细胞比例、白细胞数、单核细胞比例;②单因素分析发现,年龄、疾病种类、动员方案、采集前化疗次数、发病时有无骨髓侵犯对最终采集成功率无影响,差异均无显著性意义(均P>0.05),而性别、动员前疾病状态、体表面积与最终采集成功率有关,差异均有显著性意义(均P<0.05);③结果表明,动员后通过监测血常规来决定外周血造血干细胞采集的时间,其中主要监测白细胞数、单核细胞绝对值、单核细胞比例、淋巴细胞比例,预测价值最高的为单核细胞绝对值,其界值为1.345×109 L-1。男性、采集前疾病状态为完全缓解或部分缓解、体表面积偏大时,最终采集的成功率高。BACKGROUND:Autologous peripheral blood hematopoietic stem cell transplantation has been widely used in clinic because of its wide age range,fewer complications and low cost.The reconstitution of hematopoietic function after transplantation mainly depends on the quantity and quality of hematopoietic stem cells.Based on the clinical practice,this paper analyzes various factors affecting the collection of peripheral blood hematopoietic stem cells,and calculates the appropriate blood routine standards.It is of great significance to improve the success rate of peripheral blood hematopoietic stem cell collection and autologous transplantation.OBJECTIVE:To analyze the influence of related factors on the number of CD34^+cells during the mobilization and collection of peripheral blood hematopoietic stem cells of patients with hematological tumors.METHODS:A retrospective analysis of the effects of various factors on the number of CD34^+cells collected during the mobilization and collection of peripheral blood hematopoietic stem cells of 36 patients in Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences was performed from June 2018 to June 2020,including age,gender,body surface area,disease type,various cell levels on the day of collection,number of chemotherapy before collection,and disease before collection factors such as status,presence or absence of bone marrow involvement at the first diagnosis.RESULTS AND CONCLUSION:(1)The number of CD34^+cells was related to the number of leukocytes,the absolute value of monocytes,the proportion of monocytes,and the proportion of lymphocytes on the day of collection,and the difference was statistically significant(all P<0.05).Further analysis of the above four indicators found that the absolute value of monocytes on the day of collection had the highest predictive value for the number of CD34^+cells,followed by the proportion of lymphocytes,leukocytes,and monocytes.(2)Single factor analysis found that age,disease type,mobilization plan,the number of chemotherapy be

关 键 词：干细胞 造血干细胞 动员 外周血造血干细胞采集 自体造血干细胞移植 血液肿瘤 影响因素 

分 类 号：R457[医药卫生—治疗学] R394.2[医药卫生—临床医学]