86例淋巴瘤患者外周血造血干细胞采集影响因素分析

Analysis on the impacting factors of peripheral blood hematopoietic stem cell collection in 86 patients with lymphoma

目的探讨恶性淋巴瘤患者外周血造血干细胞采集的影响因素。方法回顾性分析昆明医科大学第一附属医院2014年2月至2020年6月收治的86例恶性淋巴瘤患者的临床资料,所有患者均行自体外周血造血干细胞移植(Auto-HSCT)方案治疗,以CD34+细胞数评价造血干细胞的采集水平,分析患者性别、年龄、肿瘤类型、血常规指标、动员采集时间、化疗时间、病程时间、是否输血等因素对采集数的影响。结果86例患者共行288次外周血造血干细胞采集,不同性别、不同动员时间、是否输血、不同白细胞水平的CD34+细胞采集数量无明显差异(P>0.05),而患者年龄、病程时间、化疗疗程、有核细胞水平是影响CD34+细胞采集数的重要因素,年龄越大、病程时间越长、化疗疗程越多、有核细胞水平越低,CD34^(+)细胞采集数量越少,差异均有统计学意义(P<0.05),多因素logistic回归分析,病程时间、化疗疗程、有核细胞水平是影响CD34^(+)细胞采集水平的独立性危险因素。结论对于年龄大、病程时间长、化疗疗程多、有核细胞水平低的患者,外周血造血干细胞的采集效率较低,淋巴瘤患者外周血造血干细胞采集要取得更好的效果,应尽早进行动员,必要时需进行两次动员采集。

Objective To investigate the impacting factors of peripheral blood hematopoietic stem cell collection in patients with malignant lymphoma.Methods The clinical data of 86 patients with malignant lymphoma admitted to and treated in the First Affiliated Hospital of Kunming Medical University from February 2014 to June 2020 were analyzed retrospectively.All patients were treated with autologous peripheral blood hematopoietic stem cell transplantation(auto HSCT).The collection level of hematopoietic stem cells was evaluated by the number of CD34+cells,and the impacting factors such as gender,age,tumor type,blood routine index,mobilization collection time,chemotherapy time,time of disease course and whether blood transfusion or not of patients on the collection number were analyzed.Results A total of 288 times of peripheral blood hematopoietic stem cell collection were performed in 86 patients.There were no significant differences in the numbers of CD34+cells collected by different gender,differ ent mobilization time,whether blood transfusion or not,and different leukocyte levels(P>0.05).However,the age,time of disease course,course of chemotherapy and level of nucleated cells were important factors impacting the number of CD34^(+)cells collected.The older the age,the longer the time of disease course,the more chemotherapy courses,the lower the level of nucleated cells,the less the number of CD34+cells collected,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that time of disease course,course of chemotherapy and level of nucleated cells were independent risk factors impacting the level of CD34^(+)cells collected.Conclusion For patients with older age,longer course of disease,more chemotherapy courses and lower level of nucleated cells,the collection efficiency of peripheral blood hematopoietic stem cells was lower.In order to achieve better results in collecting peripheral blood stem cells of patients with lymphoma,mobilization should be carried out as soon as possible,and mobilization collection should be carried out twi ce if necessary.