自体与异基因外周血干细胞移植早期造血重建的初步研究

Hematopoietic reconstitution in early period after autologous and allogeneic peripheral blood stem cell transplantation

目的探讨自体外周血干细胞移植(auto-PBSCT)患者与异基因外周血干细胞移植(allo-PBSCT)供者的动员后外周血(MPB)及产品中CD34+细胞及其亚群所占比例、数量及其在移植后造血重建中的意义。方法应用流式细胞仪分别检测16名auto-PBSCT患者和24名allo-PBSCT供者MPB及分离产品的115份标本,比较CD34+、CD34+CD38-细胞所占比例及两组患者早期造血恢复情况。结果allo-PBSCT供者MPB及分离产品中CD34+细胞比例均明显低于auto-PBSCT患者(P<0.05);MPB及分离产品中CD34+CD38-细胞亚群含量在两组人群中无显著差异(P>0.05);allo-PBSCT患者所接受的单核细胞数明显多于auto-PBSCT患者(P<0.01);两组患者移植后中性粒细胞恢复到0.5×109/L、血小板恢复到2×1010/L的时间无显著差异(P>0.05),但均与单位体质量输入的单个核细胞、CD34+、CD34+/CD38-细胞数量相关。结论无论是auto-PBSCT 还是allo-PBSCT,回输的CD34+、CD34+CD38-细胞数量是决定造血重建速度的关键因素。

Objective To investigate the ratio and amount of CD34 + cells and their subsets in mobilized peripheral blood (MPB) and leukapheresis products in patients receiving autologous peripheral blood stem cell transplantation (auto-PBSCT) and in allo-PBSCT donors, and clarify the role of CD34 + cells in post-transplantation hematopoietic reconstitution. Method Sixteen patients receiving auto-PBSCT and 24 allo-PBSCT donors were studied for CD34 + and CD34 + CD38 - cell ratios in the 115 MPB and their leukapheresis product samples by way of flow cytometry, and the time of hematopoietic recovery was observed in the two groups. Results The CD34 + cell ratio in the MPB samples and leukapheresis products was significantly lower in the donors than in auto-PBSCT patients (P<0.05), but CD34 + CD38 - cell ratio showed no obvious difference between the two groups. The amount of mononuclear cells (MNCs) received by allo-PBSCT patients was much more than that received by auto-PBSCT patients (P<0.01). Similar average times for post-transplant neutrophils recovery to over 0.5×10 9 /L and platelets to over 2×10 10 /L (P>0.05) were observed between the groups, and in both of them, the recovery was related to the amount of MNCs, CD34 + and CD34 + /CD38 - cell infusion. Conclusion Irrespective of auto-PBSCT or allo-PBSCT, the number of CD34 + and CD34 + CD38 - cells infused after the transplantation is the key factor to influence the course of hemopoietic reconstitution.