多发性骨髓瘤患者外周血造血干细胞动员的临床分析

Clinical analysis of mobilization of autologous peripheral blood stem cells in patients with multiple myeloma

目的:探讨多发性骨髓瘤(MM)患者使用化疗联合粒细胞集落刺激因子(G-CSF)进行外周血造血干细胞动员的效果及影响因素。方法:将20例MM患者检测采集物中有核细胞数及CD34+细胞数量进行回顾性分析。结果:20例患者共经过44例次单采,自化疗结束至采集日平均时间为10.55(8～14)天。获得有核细胞均数为6.01×108/kg(1.67～14.7×108/kg),CD34+细胞12.49×106/kg(1.9～38×106/kg)。仅有2例患者采集物CD34+细胞<2.5×106/kg。对比两组的临床特征,发现CD34+细胞产率与病程,动员前化疗次数,外周血白细胞恢复时间相关,而与年龄、性别、疾病状态等因素无明显相关性。结论:化疗联合G-CSF方案应用于MM患者中,绝大多数能获得足够的干细胞,对于病程长,化疗次数多动员后血象恢复时间长的患者效果不佳。

Objective：To investigate the efficacy and influential factors of the mobilization of peripheral blood stem cells（PBSCs） with combination of cyclophophamide or etoposide and recombinant human granulocyte colony-stimulating factor（rhG-CSF） in the patients with multiple myeloma.Methods：PBSCs were mobilized with chemotherapy combined with rhG-CSF and collected by leukapheresis.The amounts of mononucleated cells（MNCs） and CD34＋ cells were counted by flow cytometry.Results：Twenty patients underwent 44 leuka-pheresises,the median time from the ending of chemotherapy to the beginning of apheresis was 10.55 d（8-14 d）.The median number of MNCs and CD34＋ cells were 6.01×10^8/kg（1.67×10^8-14.7×10^8/kg） and 12.49×10^6/kg（1.9×10^6-38×10^6/kg） respectively.Two patients failed to obtain adequate PBSCs.Conclusion：It is effective and safe to mobilize PBSCs by combination of cyclophosphamide or etoposide and rhG-CSF for most patients with multiple myeloma,the patients with long period of disease and high Drake’s scores could fail to gain adequate PBSCs.