CAJ | 학술논문

背景:外周血干细胞移植的首要条件是造血干细胞有效动员和采集,并能较快持久地重建造血.近年国内外不少单位已开展了此项工作,但平均每例供者采集次数较多,且造血干细胞的产率高低差别较大. 目的:探讨健康供者外周血造血干细胞动员后采集的最佳时机.方法:2003-01/2008-12海口市人民医院进行异基因外周血造血干细胞采集的健康捐赠者16例,随机分为2组,单纯动员组6例,皮下注射粒细胞集落刺激因子5.0～10.0 μg/(kg·d),共5 d;联合组10例,在单纯动员组基础上,静脉推注地塞米松10 mg.每例供者均采集2次外周血造血干细胞,单纯动员组与联合组又各分为2 h,4 h两个亚组,即若在第4天动员后2 h采集,则第5天在动员后4 h采集;若在第4天动员后4 h采集,则第5天在动员后2 h采集.16例供者采集量为4.0～5.0 mL,推赶量3.0～5.0 mL,总循环血量6.7～10.1 L.结果与结论:单纯动员组、联合组采集的单个核细胞数均达到(4.0～8.0)×10~8 kg~(-1).与2 h亚组比较,两组4 h亚组采集物的单个核细胞数均明显增加(P < 0.05).提示粒细胞集落刺激因子动员后第4,5天进行采集,4 h采集物的细胞浓度明显高于2 h;供者采集时循环血量是其自身循环血量的1.8～2.2倍时已能一次采集足够量的细胞数,有较合理的采集时间-价值-效益的关系.
배경:외주혈간세포이식적수요조건시조혈간세포유효동원화채집,병능교쾌지구지중건조혈.근년국내외불소단위이개전료차항공작,단평균매례공자채집차수교다,차조혈간세포적산솔고저차별교대. 목적:탐토건강공자외주혈조혈간세포동원후채집적최가시궤.방법:2003-01/2008-12해구시인민의원진행이기인외주혈조혈간세포채집적건강연증자16례,수궤분위2조,단순동원조6례,피하주사립세포집락자격인자5.0～10.0 μg/(kg·d),공5 d;연합조10례,재단순동원조기출상,정맥추주지새미송10 mg.매례공자균채집2차외주혈조혈간세포,단순동원조여연합조우각분위2 h,4 h량개아조,즉약재제4천동원후2 h채집,칙제5천재동원후4 h채집;약재제4천동원후4 h채집,칙제5천재동원후2 h채집.16례공자채집량위4.0～5.0 mL,추간량3.0～5.0 mL,총순배혈량6.7～10.1 L.결과여결론:단순동원조、연합조채집적단개핵세포수균체도(4.0～8.0)×10~8 kg~(-1).여2 h아조비교,량조4 h아조채집물적단개핵세포수균명현증가(P < 0.05).제시립세포집락자격인자동원후제4,5천진행채집,4 h채집물적세포농도명현고우2 h;공자채집시순배혈량시기자신순배혈량적1.8～2.2배시이능일차채집족구량적세포수,유교합리적채집시간-개치-효익적관계.
BACKGROUND: Effective mobilization and collection of hemopoietic stem cells are initial factors for peripheral stem cell transplantation, while they make sure a permanent reconstruction of hemopoiesis. Mobilization and collection have been developed; however, the collection is more, and the yield of hemopoietic stem cells is various. OBJECTIVE: To investigate the best time of mobilization and collection of peripheral blood stem cells from healthy donors. METHODS: A total of 16 donors who were selected from Haikou People's Hospital between January 2003 and December 2008 were randomly divided mobilization group (A, n=6) and mobilization + collection group (B, n=10). A group was subcutaneously injected with 5.0-10.0 μg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF) (Filgrastim), and B group was treated with rhG-CSF and intravenously injected with 10 mg dexamethasone. Peripheral stem cells were collected twice in each group. The two groups were collected at the fourth and 5~(th) day of mobilization after the second or 4th hour subcutaneous injection of rhG-CSF. The collection was 4.0-5.0 mL, the manhandled volume was 3.0-5.0 mL, and the total blood volume was 6.7-10.1 L. RESULTS AND CONCLUSION: Number of mononuclear cells was (4.0-8.0)×10~8 kg~(-1) in the two groups. The cell concentration of fourth hour was higher than the second hour after rhG-CSF treatment (P < 0.05). The mononuclear cell concentration of fourth hour was higher than the second hour after the fourth and 5~(th) day of rhG-CSF treatment. Our research showed that we could collect sufficient amount of cells (to a high concentration) by one time, which had reasonable collection time - value-effectiveness relationship, when the cycle blood volume was 1.8-2.2 times of circulating blood volume.