CAJ | 학술논문

目的探讨外周血造血干细胞动员过程中外周血CD34+细胞的变化趋势及其对采集时机和采集结果的影响.方法 2010年4月至2011年12月外周血造血干细胞动员及采集27例,其中自体13例,采用化疗联合粒细胞集落刺激因子(G-CSF) 10μg· kg-1·d-1动员方案；健康供者14例,单独应用G-SCF 7.5μg· kg-1·d-1动员方案.监测外周血CD34+细胞数,并与采集产物中获得的单个核细胞(MNC)及CD34+细胞量进行相关性分析.结果健康供者中获得MNC(5.84±1.48)×108/kg,CD34+细胞(3.93±2.16)×106/kg.自体动员共获得MNC(6.58±3.72)×108/kg,CD34+细胞(3.98±3.06)×106/kg,仅1例自体动员、采集失败.自体动员外周血CD34+细胞在第4天达峰值,健康供者第5天仍处于上升阶段.外周血CD34+细胞百分比和绝对值与采集产物CD34+细胞呈明显正相关.采集当天CD34+细胞绝对值≥20/μ1时,单次采集获得CD34+细胞≥2×106/kg者的比例达76.2％(16/21).结论外周血CD34+细胞计数是造血干细胞采集过程中的重要监测指标,对于把握采集时机和预测采集效果具有重要意义,CD34+细胞绝对值≥20/μ1可作为采集阈值.
목적 탐토외주혈조혈간세포동원과정중외주혈CD34+세포적변화추세급기대채집시궤화채집결과적영향.방법 2010년4월지2011년12월외주혈조혈간세포동원급채집27례,기중자체13례,채용화료연합립세포집락자격인자(G-CSF) 10μg· kg-1·d-1동원방안；건강공자14례,단독응용G-SCF 7.5μg· kg-1·d-1동원방안.감측외주혈CD34+세포수,병여채집산물중획득적단개핵세포(MNC)급CD34+세포량진행상관성분석.결과 건강공자중획득MNC(5.84±1.48)×108/kg,CD34+세포(3.93±2.16)×106/kg.자체동원공획득MNC(6.58±3.72)×108/kg,CD34+세포(3.98±3.06)×106/kg,부1례자체동원、채집실패.자체동원외주혈CD34+세포재제4천체봉치,건강공자제5천잉처우상승계단.외주혈CD34+세포백분비화절대치여채집산물CD34+세포정명현정상관.채집당천CD34+세포절대치≥20/μ1시,단차채집획득CD34+세포≥2×106/kg자적비례체76.2％(16/21).결론 외주혈CD34+세포계수시조혈간세포채집과정중적중요감측지표,대우파악채집시궤화예측채집효과구유중요의의,CD34+세포절대치≥20/μ1가작위채집역치.
Objective To investigate the variation of peripheral blood CD34+ cells during the hematopoietic stem cell mobilization,and its influence on the collecting timing and results.Methods Twenty-seven cases of peripheral blood hematopoietic stem cell mobilization and collection from April 2010 to December 2011 were analyzed,including 13 autologous cases mobilized with chemotherapy combined with granulocyte colony-stimulating factor (G-CSF,10 μg· kg-1 · d-1) and 14 cases of healthy donors mobilized with only G-SCF (7.5 μg · kg- 1 · d- 1 ).The number of peripheral blood CD34+ cells was counted,and its correlation with the yield of mononuclear cells (MNCs) and CD34+cells was analyzed.Results MNCs (5.84 ± 1.48) × 108/kg and CD34+ cells (3.93 ± 2.16) × 106/kg were obtained in healthy donors,and (6.58 ± 3.72) × 108/kg MNCs and (3.98 ± 3.06) × 106/kg CD34+ cells were obtained in autologous cases,respectively.There was only 1 failure in autologous cases.The peak of peripheral blood CD34+ cells in autologous cases appeared at day 4 after the treatment of G-CSF,and in healthy donors the number of peripheral blood CD34+ cells at day 5 was still in ascendant phase.The CD34+ cells/kg in the collection products were positively correlated with the percentage and absolute value of peripheral blood CD34+ cells.The cases ratio of CD34+ cells≥2× 106/kg in the products of single collection was up to 76.2％ (16/21) in the cases with peripheral blood CD34+ cells absolute value greater than 20/μl.Conclusion The number of peripheral blood CD34+ cells was an important monitoring indicator in hematopoietic stem cell mobilization and collection,CD34+ cell absolute value ≥20/μl could be used as collection threshold.