实体瘤序贯双次移植患者自体造血干细胞采集方法及效果分析

Collection of autologous peripheral hematopoietic stem cells in patients with sequential double transplantation of solid tumors and effect analysis

目的探索实体瘤序贯双次移植患者自体外周血造血干细胞采集方法及安全性,分析采集效果。方法选择2019年1月-2021年6月行细胞采集的27名实体瘤患者为研究对象,重组人粒细胞刺激因子及重组人粒细胞巨噬细胞集落刺激因子动员后行采集术。制订个性化方案,采集前全面评估患儿病情及配合程度,建立深静脉通路,以保证采集顺利进行。选择单核细胞采集(MNC)程序,设置机器参数。采集结束后取混匀的标本进行单个核细胞计数及CD34^(+)细胞计数,做回顾性分析。结果27名患者共进行细胞采集73次,获得的单个核细胞数为12.586(10.22-19.586)×10^(8)/kg,CD34^(+)细胞数为13.575(7.275-23.825)×10^(6)/kg,满足双次自体造血干细胞移植所需。未发生枸橼酸中毒及其他严重不良反应,随访一般状况良好。结论我们的采集方法对儿童是有效和安全的,即使体重小也可推荐使用,能为实体瘤患儿采集足够的干细胞,满足序贯双次自体造血干细胞移植需要。

Objective To explore the methods and safety of autologous peripheral hematopoietic stem cells collection in patients with sequential double transplantation of solid tumors and conduct efficacy analysis.Methods Peripheral blood stem cells were collected from 27 patients with solid tumors after routine mobilization of rhG-CSF and rhGM-CSF.A specific program was made for the patients.The condition and cooperation degree of children were comprehensively evaluated before cell collection,and a femoral venous catheterization was inserted to ensure the cells collected smoothly.A mononuclear cell collection(MNC)program was selected,and machine parameters were set based on the patient’s low body weight.The number of mononuclear cell(MNC)and the CD34^(+)cell was detected by flow cytometry for retrospective analysis.Results A total of73 cell collections were performed in 27 patients,and the number of mononuclear cells and CD34^(+)cells was 12.586(10.22-19.586)×10^(8)/kg and 13.575(7.275-23.825)×10^(6)/kg,respectively,which can meet the requirement of sequential double transplantation.No intoxication of citrate and other serious adverse reactions occurred,and the follow-up was generally in good condition.Conclusion The method is effective and safe for pediatric patients,even for pediatric patients with low weight.Sufficient stem cells can be collected for patients with solid tumors by this method to meet the requirement of sequential double transplantation.