健康供者外周血造血干细胞动员后采集的最佳时机

Best time for mobilization and collection of peripheral blood stem cell from healthy donors

背景:外周血干细胞移植的首要条件是造血干细胞有效动员和采集,并能较快持久地重建造血。近年国内外不少单位已开展了此项工作,但平均每例供者采集次数较多,且造血干细胞的产率高低差别较大。目的:探讨健康供者外周血造血干细胞动员后采集的最佳时机。方法:2003-01/2008-12海口市人民医院进行异基因外周血造血干细胞采集的健康捐赠者16例,随机分为2组,单纯动员组6例,皮下注射粒细胞集落刺激因子5.0～10.0μg/(kg·d),共5d;联合组10例,在单纯动员组基础上,静脉推注地塞米松10mg。每例供者均采集2次外周血造血干细胞,单纯动员组与联合组又各分为2h,4h两个亚组,即若在第4天动员后2h采集,则第5天在动员后4h采集;若在第4天动员后4h采集,则第5天在动员后2h采集。16例供者采集量为4.0～5.0mL,推赶量3.0～5.0mL,总循环血量6.7～10.1L。结果与结论:单纯动员组、联合组采集的单个核细胞数均达到(4.0～8.0)×108kg-1。与2h亚组比较,两组4h亚组采集物的单个核细胞数均明显增加(P<0.05)。提示粒细胞集落刺激因子动员后第4,5天进行采集,4h采集物的细胞浓度明显高于2h;供者采集时循环血量是其自身循环血量的1.8～2.2倍时已能一次采集足够量的细胞数,有较合理的采集时间-价值-效益的关系。

BACKGROUND：Effective mobilization and collection of hemopoietic stem cells are initial factors for peripheral stem cell transplantation,while they make sure a permanent reconstruction of hemopoiesis.Mobilization and collection have been developed;however,the collection is more,and the yield of hemopoietic stem cells is various.OBJECTIVE：To investigate the best time of mobilization and collection of peripheral blood stem cells from healthy donors.METHODS：A total of 16 donors who were selected from Haikou People＇s Hospital between January 2003 and December 2008 were randomly divided mobilization group （A,n=6） and mobilization ＋ collection group （B,n=10）.A group was subcutaneously injected with 5.0-10.0 μg/（kg·d） recombinant human granulocyte colony-stimulating factor （rhG-CSF） （Filgrastim）,and B group was treated with rhG-CSF and intravenously injected with 10 mg dexamethasone.Peripheral stem cells were collected twice in each group.The two groups were collected at the fourth and 5th day of mobilization after the second or 4th hour subcutaneous injection of rhG-CSF.The collection was 4.0-5.0 mL,the manhandled volume was 3.0-5.0 mL,and the total blood volume was 6.7-10.1 L.RESULTS AND CONCLUSION：Number of mononuclear cells was （4.0-8.0）×108 kg-1 in the two groups.The cell concentration of fourth hour was higher than the second hour after rhG-CSF treatment （P 0.05）.The mononuclear cell concentration of fourth hour was higher than the second hour after the fourth and 5th day of rhG-CSF treatment.Our research showed that we could collect sufficient amount of cells （to a high concentration） by one time,which had reasonable collection time-value-effectiveness relationship,when the cycle blood volume was 1.8-2.2 times of circulating blood volume.