MA或MOED方案联合造血生长因子动员自体外周血干细胞效果观察

MOBILIZATION OF AUTOLOGOUS PERIPHERAL BLOOD STEM CELLS BY MITOXANTRONE-BASED BOMBINATIVE CHEMOTHERAPY AND HEMATOPOIETIC GROWTH FACTOR MOBILIZATION REGIMENS

目的 :探讨米托蒽醌 (MIT)为主的 MA或 MOED化疗方案联合造血生长因子对自体外周血干细胞 (APBSC)的动员效果。方法 :12例患者用 MA联合造血生长因子动员方案 ( 组 ) ,8例患者用 MOED联合造血生长因子动员方案 ( 组 ) ,两组均在白细胞 (WBC)降至最低点开始回升时 ,皮下注射 G- CSF或 G- CSF+GM- CSF至采集结束。 WBC恢复至 >2 .5× 10 9/ L,CD+ 34 细胞比例 >1.0 %时 ,用血细胞分离机连续 2天采集 APBSC。当累计采集的单个核细胞 (MNC)达到 4× 10 8/ kg以上时停止采集。以文献报道的环磷酰胺联合造血生长因子动员方案为对照 ( 组 )。结果 : 组动员方案在两次采集的 CD+ 34 细胞数量优于 组动员方案。 组和 组两种动员方案在第 1次采集的 CD+ 34细胞数、采集次数、骨髓抑制强度方面优于 组动员方案 ,但是第 2次采集 CD+ 34 细胞较少。 2 0例患者连续采集 APBSC 2次 ,共采集到 MNC(4.36± 2 .0 8)× 10 8/ kg,CD+ 34 细胞 (9.87± 7.30 )× 10 6 / kg,CFU- GM(2 .86± 2 .10 )× 10 4 / kg。 18例接受自体外周血干细胞移植 (APBSCT)者造血功能均获得满意重建。结论 :以 MIT为主的化疗联合造血生长因子是一种安全、高效的

Objective:To observe the efficacy of mitoxantrone based combinative chemotherapy and hematopoietic growth factor on autologous peripheral blood stem cells(APBSC) mobilization.Methods:MA mobilization regimen MOED mobilization regimen granulocyte colony-stimulating factor (G CSF) or G CSF and granulocyte macrophage colony stimulating factor (GM CSF) each,subcutaneously injected from the day of WBC recovery from nadir to the day of APBSC harvesting. APBSC harvesting started when WBC recovery to 2.5×10 9/L and CD + 34 cells percentage >1 % and finished when accumulated mononuclear cells(MNC)>4×10 8/kg.CFU GM assay and CD + 34 cells detection of the APBSC were performed.Results:Twenty cases underwent the APBSC mobilization with mitoxantrone based chemotherapy combined with hematopoietic growth factor. Accumulated MNC for two successive days was(4.35±2.08)×10 8/kg,CD + 34 cells(9.87±4.30) ×10 6/kg and CFU GM(2.86±2.10)×10 4/kg. No severe toxicity was observed.Hematopoietic reconstitution was very well in 18 patients received the APBSC transplantation.Conclusion:Mitoxantrone based chemotherapy combined with hematopoietic growth factor was a safe and highly effective method for APBSC mobilization.