外周血造血干细胞采集效果及影响因素分析  

Analysis of the efficiency and influencing factors of peripheral blood hematopoietic stem cell collection

作　　者：杨丽莎 侯宇 黄兴琴 Yang Lisha;Hou Yu;Huang Xingqin(Department of Hematology,Southwest Hospital,Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学西南医院血液科,重庆400038

出　　处：《中国医师进修杂志》2023年第4期341-344,共4页Chinese Journal of Postgraduates of Medicine

基　　金：国家自然科学基金(82170115)。

摘　　要：目的观察外周血造血干细胞采集效果,并探讨其影响因素。方法采用费森尤斯血细胞分离机、迈瑞血细胞分析仪及BD流式细胞仪,对采集过程的参数、血常规指标及产品的单个核细胞(MNC)和CD_(34)^(+)计数进行检测。回顾性分析陆军军医大学西南医院2013年1月至2021年1月共72例行自体外周血造血干细胞移植患者的性别、年龄、血常规指标、采集循环量与采集物MNC和CD_(34)^(+)计数相关性以及各因素对外周血干细胞采集效果的影响。结果不同年龄、性别和疾病类型的患者外周血干细胞采集效果差异无统计学意义(P>0.05)。所有患者采集物的MNC与采集循环量(r=0.33,P<0.001)、动员后白细胞计数(r=0.41,P<0.001)呈正相关,CD_(34)^(+)计数与动员后MNC计数(r=0.38,P<0.001)和收集白膜量(r=0.48,P<0.001)呈正相关。多元回归分析结果显示,动员后MNC计数[P<0.001,95%CI 0.07(0.05~0.09)]、采集循环量[(P<0.001,95%CI 0.00(0.00~0.00)]、采后总量[P<0.001,95%CI 0.07(0.05~0.10)]是采集物MNC计数的影响因素。此外,动员后MNC计数[P<0.001,95%CI 0.09(0.04~0.14)]、采集循环量[P=0.003,95%CI 0.00(0.00~0.00)]、采后总量[P=0.005,95%CI 0.08(0.03~0.14)]也是CD_(34)^(+)计数的影响因素。结论外周血干细胞的采集效率个体差异大,动员后MNC计数越多,采集到的外周血干细胞量越多。要想获得高的采集效率,需要有针对性地调整好采集前外周血MNC等参数,并注意采集循环量、采后总量和收集白膜量。Objective To investigate the collection efficiency of peripheral blood hematopoietic stem cells and explore its influencing factors.Method The parameters of the collection process,blood routine indexes and the number of MNC and CD_(34)^(+)cells of the product were detected by Fresenius blood cell separator,Mindray blood cell analyzer and BD flow cytometer.A retrospective analysis was performed on 72 patients who underwent autologous peripheral blood hematopoietic stem cell transplantation in Southwest Hospital of Army Medical University from January 2013 to January 2021,including the correlation among gender,age,blood routine indexes,collection circulation volume and MNC and CD_(34)^(+)cell count in these cases,and influence of various factors on collection efficiency of peripheral blood stem cells.The correlation among gender,age,blood routine indexes,collection circulation volume and MNC and CD_(34)^(+)cell count in 72 cases of autologous transplantation patients,and influence of various factors on collection efficiency of peripheral blood stem cells were analyzed retrospectively.Results There were no significant differences in collecting efficiency of peripheral blood stem cells among patients with different age,sex and disease type(P>0.05).The collected MNC count of all patients was positively correlated with the collection cycle count(r=0.33,P<0.001)and WBC count after mobilization(r=0.41,P<0.001).The number of CD_(34)^(+)cells collected was positively correlated with MNC count after mobilization(r=0.38,P<0.001)and the amount of white membrane collected(r=0.48,P<0.001).Logistic multivariate regression analysis showed that MNC count after mobilization:P<0.001,95%CI 0.07(0.05-0.09),collection cycle amount[P<0.001,95%CI 0.00(0.00-0.00)]and postharvest total amount[P<0.001,95%CI 0.07(0.05-0.10)]were the influencing factors of the collected MNC number.Meanwhile,these factorswere also the influencing factors of the collected CD_(34)^(+)number(MNC count after mobilization:P<0.001,95%CI 0.09(0.04-0.14);collection cy

关 键 词：造血干细胞移植 外周血 采集效果 影响因素 

分 类 号：R457.7[医药卫生—治疗学]