应用粒细胞集落刺激因子动员后异基因外周血干细胞移植供者外周血干细胞与不成熟粒细胞的相关性

Correlation between CD34^＋ cell and immature granulocyte in donor＇s peripheral blood by rhG-CSF

目的探讨供者应用重组人粒细胞集落刺激因子（rhG—CSF）动员后单采外周血干细胞（PBSC）移植物中的不成熟粒细胞与CD34^＋细胞及单个核细胞（MNC）之间的相关性。方法122例异基因外周血干细胞移植（allo—PBSCT）供者用rhG—CSF7．25～10μg·kg^-1·d^-1进行动员，于动员前及动员后对外周血及PBSC收集物中的MNC和不成熟粒细胞及C融细胞进行检测，并计算出输给患者的MNC、不成熟粒细胞及CD34^＋细胞数。结果动员后白细胞计数及不成熟粒细胞比值逐渐升高，至第5天达高峰；外周血MNC中不成熟粒细胞与CD34^＋细胞同步增加有较好的相关性；采集后的PBSC移植物输给患者后，均全部植活并恢复造血功能，为染色体核型或血型及HLA转为供者型所证实，慢性粒细胞白血病患者Phi染色体转阴。结论rhG—CSF7．25～10μg·kg^-1·d^-1。分两次皮下注射能有效动员PBSC；allo—PBSCT供者经rhG—CSF动员后，外周血MNC中不成熟粒细胞与CD3＋4细胞数同步增加有较好的相关性，不成熟粒细胞的数量可间接反映干／祖细胞的数量，故MNC与不成熟粒细胞数结合可作为allo—PBSCT的剂量阈标准。

Objective To investigate the correlation between immature granulocyte and CD34^＋ cells, mononuelear cells （MNC） in donor＇s peripheral blood by recombinant human granulocyte colony-stimulating factor （rhG-CSF）. Methods The stem cell were mobilized by rhG-CSF 7.25-10 μg·kg^-1·d^-1 from 122 allo- PBSCT donors. Before and after mobilization, to test CD34^＋ cells of peripheral blood stem cell graft and number of MNC, immature granulocyte, CD34^＋ cell per patient＇ weight were calculated. Results White blood cell count and immature granulocyte gradually increased, and reached the peak on the fifth day. There was a good relationship between increased immature granulocytes and increased CD34^＋ cells. The patients all achieved completed donor engraftment and achieved hematopoietic recovery. The chromosome, blood type and HLA type were transformed to be donor＇s type. Phl changed to be negative in CML patients. Conclusion rhG- CSF （7.25N10 μg·kg^-1·d^-1 ） had a good effect to mobilize PBSC. There was a good relationship between in- creased immature granulocytes and increased CD34^＋ cells after mobilization by rhG-CSF. The number of immature granulocytes can reflect indirectly the count of stem/progenitor, so the MNC and immature granulocytes can become a threshold of dosage standard.