造血干细胞动员和采集对正常供者的影响

Effects of mobilization and collection of hemopoietic stem cells on normal donors

背景:粒细胞集落刺激因子动员是当前健康志愿供者采用的主要方法。据国内外文献报告:在粒细胞集落刺激因子动员中已发生少数严重不良反应,这引起了国人对中国非血缘健康供者安全的忧虑。粒细胞集落刺激因子作为动员剂对健康志愿供者有何影响?是否安全?目的:观察粒细胞集落刺激因子对正常供者的影响。方法:选择2003-01/2008-12在海口市人民医院接受粒细胞集落刺激因子5～10μg/(kg·d)动员剂进行外周血造血干细胞捐赠者16例,观察动员及采集过程的不良反应,检测动员前后血常规CD3、CD19、CD3+4、CD3+8细胞比值在动员前后变化,并随访所有供者。结果与结论:10例供者在重组人粒细胞集落刺激因子动员过程中无任何不适,有3例出现低热,头痛、肌肉及骨骼疼痛、腰痛等,3例供者出现发热,其严重程度均在Ⅰ级,但无需终止动员。白细胞经重组人粒细胞集落刺激因子动员后数量较动员前升高,停止动员后3d全部供者的白细胞恢复至动员前水平。血红蛋白、血小板、CD3、CD19、CD3+4、CD3+8细胞比值在动员前、动员后72,96h无明显变化。提示健康供者可耐受粒细胞集落刺激因子5～10μg/(kg·d),动员和采集过程;且对T细胞亚群无影响。

BACKGROUND：Mobilization of granulocyte colony-stimulating factor （G-CSF） is a main method used in healthy voluntary donor.Previous studies have demonstrated that some severe adverse effects occurred in mobilization of G-CSF.This leads to anxiety of the safety of unrelated healthy donors.Will the mobilization of granulocyte colony-stimulating factor have any effect on healthy voluntary donor？ It remains unknown whether it is safe？ OBJECTIVE：To investigate the effect of G-CSF on healthy donors.METHODS：A total of 16 healthy donors were mobilized using G-CSF at a dose of 5-10 μg/kg per day at Haikou People＇s Hospital from January 2003 to December 2008.The adverse events were recorded during the process of mobilization and collection.Percentage of CD3,CD19,CD3＋4,CD3＋8 cells in blood was detected prior to and following mobilization.All donors were followed-up.RESULTS AND CONCLUSION：No adverse effects were determined during G-CSF mobilization in 10 donors.Three cases affected low-grade fever,headache,muscle and skeleton pain or lumbago.Three cases suffered from fever.Severity was in grade I,which does not cause the termination of the mobilization.Leukocyte number was greater following G-CSF mobilization than prior to mobilization.Leukocyte count returned to pre-mobilization levels at 3 days following stopping mobilization.There was no significant difference in hemoglobin and platelet counts,the percentage of CD3,CD19,CD3＋4,CD3＋8 cells in blood between pre-mobilization and 72 and 96 hours post-mobilization.Results have indicated that the healthy donors can tolerate the mobilization at a dose of 5-10 μg/kg per day,and G-CSF dose not affect the lymphocyte subsets.