肿瘤患者外周血干细胞动员过程中CD_(34)^+细胞的动态变化及意义

Changes of the number of CD_(34)^+ cell during the mobilization of peripheral blood stem cell in cancer patients

为观察肿瘤患者 CD+ 34 细胞数量在动员过程中的动态变化 ,确定采集干 /祖细胞的最佳时机 ,采用环磷酰胺 (CTX)联合粒细胞集落刺激因子 (G- CSF)对 2 1例肿瘤患者进行造血干 /祖细胞动员。动员过程中 ,每天进行血细胞计数 ,于前期、极期、恢复早期、恢复期计数外周血 CD+ 34 细胞、白细胞 (WBC)、单核细胞 (MNC)、血小板(Plt)。结果显示 ,不同患者出现极期、恢复早期、恢复期的时间差异较大。与前期相比 ,极期 CD+ 34 明显降低(P<0 .0 5 ) ,恢复期则显著增加 (P<0 .0 1)。WBC、MNC、Plt变化均与 CD+ 34 细胞变化呈显著正相关 (r分别为 0 .99、0 .82 7、0 .886 ,P均 <0 .0 1)。提示在 WBC>5 .0× 10 9/ L时采集外周血造血干细胞 (PBSC)较合适 ,MNC>1.5×10 9/ L时采集 PBSC较理想 ,监测 Plt计数变化 。

To observe the changes of the number of CD + 34 cells in the mobilization of stem cell in cancer patients so that the optimal time for stem/progenitor cell collection can be defined.Granulocyte colony stimulating factor combined with cyclophosphamide was administered to 21 patients with cancer to mobilize the stem/progenitor cells.Complete blood cell count was tested daily during the mobilization.CD + 34 cells,white blood cells(WBC),mononucleated cells(MNC) and platelets in peripheral blood were measured in pre mobilization stage,nadir stage early recovering stage,recovering stage respectively.The results showed that the time of occurence of nadir stage,early recovering stage and recovering stage varies widely in different patients.During the morbilization,there were distinct positive correlations between the number of WBC,MNC,platelets and CD + 34 cells as hemopoiesis recovers in the bone marrow(r were 0.99,0.827,0.886,respectively.P<0.01).These suggest it may be the optimal time for stem/progenitor cell collection when WBC>5.0×10 9/L or MNC>1.5×10 9/L.Monitoring plaletet count may also help to define the time for stem cell collection.