体重不超过20公斤的重型地中海贫血患儿外周血干细胞的动员和采集  

Peripheral blood stem cells collection in pediatric patients with thalassemia major weighing 20 kilogram or less

作　　者：温建芸[1] 陈丽白[1] 杜晶 徐肖肖 何岳林[1] 阮永胜[1] 李秀 李娟[1] 吴学东[1] WEN Jianyun;CHEN Libai;DU Jing;XU Xiaoxiao;HE Yuelin;RUAN Yongsheng;LI Xiu;LI Juan;WU Xuedong(Depart-ment of Pediatrics,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院儿科,广东广州510515

出　　处：《中国输血杂志》2023年第6期500-504,共5页Chinese Journal of Blood Transfusion

基　　金：广东省科技攻关计划(2016A020215102)。

摘　　要：目的评价体重不超过20公斤(kg)的重型地中海贫血(TM)患儿外周血干细胞(PBSCs)动员和采集的安全性和有效性。方法回顾性分析2013年1月至2020年12月本中心170例体重不超过20 kg的TM患儿的PBSCs动员和采集数据。通过采集过程中不良反应的发生情况评估安全性,通过采集的CD34细胞数评估有效性。结果对170例体重不超过20 kg的TM患儿进行171次PBSCs采集,平均年龄(4.98±1.53)岁,平均体重(17.30±2.18)kg。第1次采集成功率99.41%(169/170),获得的平均CD34^(+)细胞数为(5.88±4.23)×10^(9)/kg。对于体重≤20 kg的TM患儿,采集前血红蛋白(Hb)至少在60 g/L是安全可行的。粒细胞集落刺激因子(G⁃CSF)动员最常见的不良反应是骨痛,发生率为7.65%(13/170),高于本院健康儿童供者;采集中最常见的不良反应是股静脉穿刺部位疼痛(6.47%,11/170)和进液低压(2.92%,5/170)。所有患儿均未发生与PBSCs动员、中心静脉导管(CVC)放置或单采手术相关的严重并发症。结论体重≤20 kg的TM患儿通过COM.TEC血细胞分离机采集PBSCs是安全且有效的。Objective To evaluate the safety and efficacy of the collection of peripheral blood stem cells(PBSCs)in pediatric patients with thalassemia major(TM)weighing 20 kg or less.Methods PBSCs collection data of 170 pediatric pa⁃tients with TM weighing 20 kg or less from January 2013 to December 2020 in our center were reviewed.Safety was assessed by the occurrence of adverse events during apheresis procedures,and efficacy was evaluated by the number of CD34^(+)cells collected.Results A total of 171 PBSCs procedures were performed on 170 patients with TM weighing 20 kg or less,with a median age of(4.98±1.53)years and a median weight of(17.30±2.18)kg.The probability of collecting at least 1×10^(6) CD34^(+)cells/kg during a single course of apheresis was 99.41%(169/170),with a median(5.88±4.23)×10^(6) CD34^(+)cells collected per kg of weight of the recipient.A minimum pre⁃apheresis hemoglobin(Hb)of 60 g/L in patients with TM weig⁃hing 20 kg or less was safe and feasible.The most common adverse event of G⁃CSF mobilization in TM patients is bone pain,with the incidence of 7.65%(13/170),which was higher than that of healthy children donors in our center.The most com⁃mon adverse events during the collection were pain at the puncture site of the femoral vein(6.47%,11/170)and low pres⁃sure of the fluid(2.92%,5/170).And no serious complications related to PBSCs mobilization,central venous catheter(CVC)placement or the apheresis procedure occurred.Conclusion PBSCs collection by COM.TEC blood cell separator in children weighing 20 kg or less is safe and effica⁃cious.

关 键 词：外周血干细胞 动员 采集 不超过20公斤 重型地中海贫血 

分 类 号：R556[医药卫生—血液循环系统疾病] R457.1[医药卫生—内科学]