造血干细胞动员及采集的影响因素

Progenitor cell mobilization:factors that influence mobilization of peripheral blood stem cells

目的研究影响外周血干细胞的动员及采集因素。方法35例血液病患者予以化疗+粒细胞集落刺激因子(G-CSF)动员,15例正常供者予以G-CSF动员。用Cobe Spectra血细胞分离机采集外周血干细胞。结果外周血造血干细胞的有效动员与被动员者的年龄、性别、体表面积、采集的循环血量及骨髓是否曾经累及无关,而与动员所应用的化疗的种类相关;以环磷酰胺(CTX)为主的化疗+G-CSF动员优于柔红霉素+阿糖胞苷(DA)+G-CSF(P<0.01);CTX为主的化疗+G-CSF动员产品单个核细胞与中剂量阿糖胞苷+G-CSF动员无统计学差异,CD34+含量则CTX组显著优于DA组(P<0.05);中剂量阿糖胞苷+G-CSF动员与DA+G-CSF动员方案相比较,两组无统计学差异(P>0.05)。结论外周血造血干细胞的有效动员与动员所应用的化疗种类相关,CTX为主的化疗+G-CSF动员效果最佳,蒽环类药物动员效果相对较差并动员前尽量减少使用。

Objective To study the factors that influence the mobilization of peripheral blood stem cells. Methods The records of 50 persons （35 patients and 15 donors） were retrospectively reviewed. CD34 ＋ cell mobilization was done with chemotherapy ＋ granulocyte colony-stimulating factor （G-CSF） in patients and G-CSF alone in the donors. Peripheral blood stern cells were harvested with Cohe Spectra. Results No significant correlation was found between peripheral blood stem cell mobilization and age, gender, body surface area, blood volumes of whole blood processed and bone marrow involvement. While the kind of chemotherapeutic agents was correlated with mononuclear cell （MNC） and CD34^＋ cell yield. Within classes, chemotherapy with cyclophoshamide （CTX） ＋ G-CSF was more effective on MNC and CD34^＋ cell yield than doxoruhicin ＋ cytosine （DA） ＋ G-CSF（P 〈 0. 01）. Compared with mid-dose cytosine arabinoside ＋ G-CSF, chemotherapy with CTX ＋ G-CSF was more effective in CD34^＋ cell yield（ P 〈 0. 05） , and there was no significant difference in MNC yield between the two groups. There was no significant difference between mid-dose cytosine arahinoside ＋ G-CSF with DA ＋ G-CSF（ P 〉 0. 05）. Conclusion Peripheral blood stern cell mobilization is associated with the kind of chemotherapy applied. CTX ＋ G-CSF is more effective in the mobilization of peripheral blood stem cells, while ruhidomycin should he minimized prior to mobilization.