Miller A, Morrison D, Safah H, Cullins S, Larussa V, Rink J, Weiner R
Tulane University Medical Center, New Orleans, LA 70112, USA.
J Hematother Stem Cell Res. 2000 Aug;9(4):475-80. doi: 10.1089/152581600419134.
The purpose of this study was to determine the quality of peripheral blood progenitor cells (PBPC) collected after an initial autologous PBPC transplant. Tandem autologous transplants have been used in the treatment of several malignancies. Routinely, PBPC have been collected prior to the first transplant and used for both transplants. In the current study, PBPC harvested prior to the first high-dose therapy (HDT) were used as a source of progenitors for transplant 1, and a combination of bone marrow harvested prior to the first course of HDT and PBPC collected approximately 85 days after the first transplant were used to support the second HDT. We analyzed the quality of the PBPC collected 85-120 days after HDT and autologous PBPC transplant. CD34 and colony-forming units granulocyte-macrophage (CFU-GM) contents of those collections were poor, and hematopoietic recovery was more consistent with recovery from a bone marrow transplant than a PBPC transplant. Thirteen of 15 patients received both transplants. Days to absolute granulocyte count of 500 was 10 +/- 1.5 for the first transplant and 13.3 +/- 3.7 for the second (p < 0.01). The number of days to platelet count of 20,000 was 14.3 +/- 10.7 for the first transplant and 18 +/- 7 for the second transplant (p = 0.066). The number of days of total parenteral nutrition (TPN) and intravenous morphine used by patients for the first and second transplants was similar, whereas the length of hospitalization was 21.8 +/- 3.6 for the first transplant and 27.6 +/- 7.8 for the second transplant (NS). In conclusion, it appears that the quality of PBPC collected following a previous PBPC transplant may be compromised.
本研究的目的是确定初次自体外周血祖细胞（PBPC）移植后所采集的外周血祖细胞的质量。串联自体移植已用于多种恶性肿瘤的治疗。常规情况下，PBPC在首次移植前采集并用于两次移植。在本研究中，首次大剂量治疗（HDT）前采集的PBPC用作移植1的祖细胞来源，首次HDT疗程前采集的骨髓与首次移植后约85天采集的PBPC的组合用于支持第二次HDT。我们分析了HDT和自体PBPC移植后85 - 120天采集的PBPC的质量。这些采集物中CD34和粒细胞 - 巨噬细胞集落形成单位（CFU - GM）含量较差，造血恢复更符合骨髓移植后的恢复情况，而非PBPC移植。15名患者中有13名接受了两次移植。第一次移植时达到绝对粒细胞计数500的天数为10±1.5天，第二次为13.3±3.7天（p < 0.01）。第一次移植时达到血小板计数20,000的天数为14.3±10.7天，第二次移植为18±7天（p = 0.066）。患者第一次和第二次移植使用全胃肠外营养（TPN）和静脉注射吗啡的天数相似，而住院时间第一次移植为21.8±3.6天，第二次移植为27.6±7.8天（无显著差异）。总之，先前PBPC移植后采集的PBPC质量似乎可能受损。
