小体重供者外周血造血干细胞采集方法探讨

Study on the methods of collecting peripheral blood hematopoietic stem cells from low weight pediatric donors

目的探讨小体重供者外周血造血干细胞采集方法。方法1岁4个月男性幼儿供者(11.6kg),常规重组人粒细胞刺激因子动员后采集外周血造血干细胞。选取股静脉置管为血管通路,根据供者具体情况制订采集方案;选择单个核细胞采集(MNC)程序,基于供者低体重设置机器参数;采集前、采集中进行心理疏导和人文关怀,以取得患儿及家长的配合。结果进行两次外周血造血干细胞采集,共采集单个核细胞(MNC)19.75×10^(8)/kg(受者体重),CD34^(+)细胞23.28×10^(6)/kg,达到移植所需干细胞要求。供者随访1周、1个月、3个月、6个月、12个月健康状况良好;受者其同胞姐姐(8岁6个月,26kg),因尼曼匹克病接受造血干细胞移植,白细胞植入时间11d,血小板植入时间12d,移植后+19d顺利出仓,随访18个月余病情稳定。结论运用恰当的方法,低体重幼儿供者可以采集到足够数量的外周血造血干细胞,满足较大体重受者移植所需。

Objective To explore the methods of peripheral hematopoietic stem cells collection from low weight pediatric donors.Methods A 1-month-old male donor(11.6kg)was collected from peripheral blood after routine mobilization of recombinant human granulocyte stimulating factor.A femoral venous catheterization was inserted before collection.The specific program was made for the donor.A mononuclear cell collection(MNC)program was selected,and machine parameters were set based on the donor′s low body weight.Psychological counseling and humanistic care were conducted before and during the collection to obtain the cooperation of donors and their caregivers.Results Two times of hematopoietic stem cells were collected from peripheral blood.A total of 19.75×10^(8)/kg of mononuclear cells(MNC)and 23.28×10^(6)/kg of CD34^(+)cells were collected,which met the requirement of stem cells transplantation.The donor was in good health at 1 week,1 month,3 months,6 months and 12 months.The donor′s sister was 8 years and 6 months old(26kg)received peripheral blood hematopoietic stem cell transplantation for Niemann Pick′s disease.The time of leukocyte implantation was 11days,and the time of platelet implantation was 12days.The patient was discharge from the transplantation ward after+19 days of transplantation,and the condition was stable after 18 months of follow-up.Conclusions With appropriate methods,peripheral blood hematopoietic stem cells can be collected from low body weight donors.It will meet the needs of transplantation for the larger weight patients.