儿童外周血造血干细胞采集影响因素分析

Analysis of Influencing Factors in Collection of Peripheral Hematopoietic Stem Cells in Children

目的探讨性别、年龄、外周血白细胞(WBC)和单个核细胞(mononuclear cell,MNC)计数对儿童外周血造血干细胞采集效果的影响。方法收集2016年1月~2018年1月期间,本院采集的儿童外周血干细胞28例,年龄2岁10个月~14岁,中位年龄10岁。共采集31次,自体7例次采用化疗+粒系集落刺激因子动员,异体24例次采用粒系集落刺激因子动员,均在动员后4~5 d进行外周血干细胞采集。单次平均循环血量(7593±2248)ml,单次产品体积(126±42)ml。干细胞产品进行血常规计数和流式细胞仪检测CD34^+细胞数量。结果儿童外周血干细胞单次采集产品MNC与性别、年龄无关(P=0.44;P=0.81),与外周血WBC、MNC计数相关(P=0.03;P=0.01),产品CD34^+细胞数与性别、年龄、外周血WBC无关(P=0.15;P=0.79;P=0.66),与采前MNC计数相关(P=0.02)。其中24例患者采集前外周血MNC>3.75×10~9/L,单次采集的干细胞产品MNC数为(9.88±3.16)×10~8/kg,CD34+细胞数为(7.51±4.74)×10~6/kg。结论外周血MNC数量是儿童外周血造血干细胞采集效率的重要影响因素,动员后外周血MNC数量>3.75×10~9/L,具有做为造血干细胞动员效果评价指标的应用价值。

Objective To observe the effects of gender,age,peripheral blood WBC and MNC count on the collection of peripheral blood hematopoietic stem cells in children. Methods From January 2016 to January 2018,28 cases of peripheral blood hematopoietic stem cells collected in the hospital,ranging in age from 2 to 10 years and the median age was 10. Among 31 collections,7 autologous cases were given chemotherapy combined with granulocyte colony stimulating factor（GCSF） for mobilization,and 24 allogenic cases received GCSF mobilization,and 4-5 days later,peripheral blood hematopoietic stem cells were collected. The mean single circulating blood volume was 7 5 9 3±2248 mL and the single product volume was 126 ±42 mL. Stem cell products were subjected to blood routine counting and flow cytometry to determine the number of CD34^＋ cells. Results Achievements of monocytes（MNCs） were uncorrelated to gender and age（P =0.44; P =0.81） in single collection but associated with counts of peripheral WBCs and MNCs（P =0.03; P =0.01）.Moreover,CD34^＋ cell counts were found to be not associated with gender,age and peripheral WBCs counts（P =0.15;P =0.79; P =0.66）,but with pre-harvest counts of MNCs（P =0.02）. Twenty four patients had MNCs3.75×10^9/L before collection. The number of MNCs in single-collected stem cell products was 9.88±3.16×10^8/kg and the number of CD34^＋ cells was 7.51±4.74×10^6/Kg. Conclusion The number of MNCs in peripheral blood is an important factor affecting the collection efficiency of peripheral blood hematopoietic stem cells in pediatrics. The number of peripheral blood MNCs3.75×10^9/L after mobilization would benefit for evaluation of the effect of hematopoietic stem cell mobilization.