外周血CD34^(+)细胞计数对外周血干细胞采集时机选择及结果的影响  

Effects of peripheral blood CD34^(+)cells count on the collection timing and results of peripheral blood stem cells

作　　者：白敏[1] 王列样[1] 李振华[1] 王江涛[1] 关涛[1] 刘小兰[1] 张宗[1] 赵瑾[1] 苏丽萍[1] Bai Min;Wang Lieyang;Li Zhenhua;Wang Jiangtao;Guan Tao;Liu Xiaolan;Zhang Zong;Zhao Jin;Su Liping(Department of Hematology,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院血液科,太原030013

出　　处：《肿瘤研究与临床》2021年第9期681-684,共4页Cancer Research and Clinic

基　　金：山西省科技攻关项目(20140313011-9)。

摘　　要：目的探讨外周血造血干细胞动员过程中外周血CD34^(+)细胞计数的变化趋势及其对采集时机选择和采集结果的影响。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的62例血液病患者临床资料,采用化疗联合粒细胞集落刺激因子(G-CSF)的动员方案,监测外周血及采集物中白细胞计数(WBC)、单个核细胞计数(MNC)及CD34^(+)细胞计数,并进行相关性分析,同时应用受试者工作特征(ROC)曲线确定最佳采集阈值。结果62例患者共采集136例次,获得MNC(5.66±1.11)×10^(8)/kg,CD34^(+)细胞计数(2.15±1.20)×106/kg。外周血CD34^(+)细胞计数在应用G-CSF后第4、5天达最高峰,之后呈下降趋势。产物中CD34^(+)细胞计数与采集当天外周血CD34^(+)细胞计数具有相关性(r=0.879,P<0.01),与采集当天外周血WBC及MNC产物中MNC亦具有相关性(均P<0.05)。应用ROC曲线得出采集当天外周血CD34^(+)细胞计数>23/μl为最佳采集阈值,85.2%符合阈值的患者可以一次采集成功。结论外周血CD34^(+)细胞计数的变化趋势可指导临床把握干细胞采集的最佳时机,外周血CD34^(+)细胞计数是预测采集产物中CD34^(+)细胞计数的可靠参考指标。外周血CD34^(+)细胞计数>23/μl可作为采集阈值。Objective To investigate the variation trend of peripheral blood CD34^(+)cells during the hematopoietic stem cell mobilization and its influence on the collection timing and results.Methods The clinical data of 62 patients with hematologic diseases undergoing autologous peripheral blood hematopoietic stem cell mobilization from April 2012 to March 2017 in Shanxi Provincial Cancer Hospital were analyzed.Mobilization regimen used chemotherapy combined with granulocyte colony-stimulating factor(G-CSF)to monitor the number of white blood cells(WBC),mononuclear cells(MNC),CD34^(+)cells in peripheral blood and apheresis concentrates,and the correlation with CD34^(+)cells was analyzed.Furthermore,the receiver operating characteristic(ROC)curve was used to establish the threshold to start apheresis.Results MNC(5.66±1.11)×10^(8)/kg and CD34^(+)cell count(2.15±1.20)×106/kg were obtained in 62 patients who received 136 times collection in total.The peak of peripheral blood CD34^(+)cells count appeared at day 4-5 after the treatment of G-CSF,and then it went down.CD34^(+)cell count in the product was correlated with the peripheral blood CD34^(+)cell count collected on the day(r=0.879,P<0.01),and it was also correlated with the peripheral blood WBC and MNC collected on the day as well as MNC count in the product(all P<0.05).Furthermore,the ROC curve analysis demonstrated that peripheral blood CD34^(+)cells count>23/μl was the optimal threshold for stem cell collection on the day,85.2%of patients reaching up to the threshold could be successfully collected at one time.Conclusions The variation trend of peripheral blood CD34^(+)cell count can guide the best time of stem cell collection in clinic.Peripheral blood CD34^(+)cell count is the reliable index to predict CD34^(+)cells count in the products.Peripheral blood CD34^(+)cells count>23/μl could be used as the collection threshold.

关 键 词：外周血 CD34^(+)细胞 干细胞动员 干细胞采集 

分 类 号：R457.7[医药卫生—治疗学]