应用重组人粒细胞集落刺激因子对不同人群骨髓CD34^+细胞和T细胞亚群影响的动态观察

Effects of Granulocyte-colony stimulating factor on bone marrow CD34^+ cell and T lymphocyte subset.

目的 探讨健康人及处于完全缓解的恶性肿瘤患者 ,在应用重组人粒细胞集落刺激因子(G CSF)期间 ,其骨髓CD34+ 细胞和T细胞亚群的动态变化特点。方法 12例异基因外周血干细胞移植健康供者和 16例自体外周血干细胞移植患者 ,在接受G CSF(30 0 μg/d ,共 5d)动员外周血干细胞期间 ,应用流式细胞仪测定其骨髓CD34+ 细胞和T细胞亚群。结果 ①恶性肿瘤患者未应用G CSF时 ,骨髓细胞中CD34+ 细胞的初始值为 (0 .5 2± 0 .31) % ,同等条件下正常供者骨髓细胞中CD34+ 细胞的测定值为 (1.2 0±0 .6 8) % ,两者有显著差异 (P <0 .0 1)。应用G CSF 4 8h后 ,两者的测定值分别为 (1.2 2± 0 .4 2 ) %和(2 .0 7± 0 .5 2 ) % ,CD34+ 细胞均较前有明显增加 (P <0 .0 1) ,且两者之间仍存在明显差异 (P <0 .0 1)。CD34+ 细胞的高峰值出现在应用G CSF 96h后 ,分别为 (2 .2 3± 0 .34) %和 (2 .4 4± 0 .5 4 ) % ,分别较未应用G CSF时差异显著 (P <0 .0 1) ,两者之间无差异 (P >0 .0 5 )。②无论是否应用G CSF ,恶性血液病患者的T淋巴细胞亚群比例均处于倒置状态 ,而正常供者的T淋巴细胞亚群则比例正常。随两者应用G CSF后CD34+ 细胞的逐渐增加 ,T淋巴细胞亚群变化不明显。结论 完全缓解的恶性血液病患者 ,在应用G CSF4

Objective To explore the changes of bone marrow CD34 + cells and T lymphocyte subsets after using Granulocyte colony stimulating factor(G CSF) with donors and patients.Methods Flow cytometry was used to detect the changes of CD34 + cells and T lymphocyte subsets everyday for 5 days in 12 cases of donors with allo genetic peripheral blood stem cell transplantation and 16 cases of patients with autologic peripheral blood stem cell transplantation after they were injected G CSF 300 μg/d for mobilization of peripheral blood stem cells.Results ①The percentage of CD34 + cells in the patient′s bone marrow was (0.52±0.31)% before the use of G CSF,which was (1.20±0.68)% in the normal donors,with significant difference(P<0.01),but it became (1.22±0.42)% and (2.07±0.52)% in patients and normal donors,respectively,48 hours after using G CSF,with significant difference(P<0.01).After 96 hours the percentages peaked to(2.23±0.34)% and (2.44±0.54)%,respectively,with significant difference as compared with that without G CSF(P<0.01).②CD4/CD8 in the donors were normal but they were abnormal in the patients either they used G CSF or not.There were no obvious changes in the donor′s and patient′s T lymphocyte subsets after using G CSF for days and CD34 + cells increased gradually.Conclusion The determination of bone marrow CD34 + positive cell after 48 h use of G CSF in the patients with CR contributes to the judgement of hematopoietic function.CD4/CD8 may reflect abnormality of immunology of the CR patients,Whether the patients use G CSF or not.