Hénon P, Sovalat H, Bourderont D, Ojeda-Uribe M, Arkam Y, Wunder E, Raidot J P, Husseini F, Audhuy B
Institut de Recherche en Hématologie et Transfusion, Hôpitaux de Mulhouse, Colmar, France.
Stem Cells. 1998;16 Suppl 1:113-22. doi: 10.1002/stem.5530160814.
Using three different statistical tests in parallel, we showed in a preliminary study that neither mononuclear cells, CD34+ 33+ or 33- cells, nor CD34+ 38+ cells significantly correlated with engraftment kinetics following autologous blood cell transplantation (ABCT). We additionally demonstrated here, in a series of patients suffering from malignant diseases, that the graft content in CD34+ 38- cells is individually a more sensitive indicator of the earliest, as well as the latest post-ABCT trilineage hematopoietic recovery than the colony-forming units-granulocyte-macrophage and even the total CD34+ cell content. This suggests that the CD34+ 38- cell population is itself subdivided into two more subsets, one being already lineage-committed and responsible for short-term engraftment, the other containing only very primitive hematopoietic cells responsible for sustained engraftment. Strong arguments favor the probability that these subsets correspond to HLA-DR+ and DR cells, respectively. We also defined an optimal threshold value of 0.05 x 10(6) CD34+ 38- cells/kg of the patient's body weight (b.w.) above which a rapid and sustained trilineage engraftment safely occurs. In fact, infusion of lower numbers of cells seems to have a more significant impact on long-term compared to short-term neutrophil recovery and on platelet kinetics engraftment. We additionally looked for the eventual influence on engraftment time of the type of disease, and of post-ABCT administration of hematopoietic growth factors (HGF). When the type of disease appeared to have no influence on the engraftment time, posttransplant HGF administration significantly reduced the time to trilineage engraftment in patients transplanted with < 0.05 x 10(6) CD34+ 38- cells, thus justifying it in case of reinfusion of low numbers of CD34+ 38- cells. On the other hand, the administration of HGF after infusion of more than 0.05 x 10(6) CD34+ 38- cells/kg b.w. did not hasten more, or only very little, the engraftment time, thus becoming not only unprofitable for the patients but costly as well.
我们在一项初步研究中同时使用三种不同的统计测试方法，结果表明，在自体血细胞移植（ABCT）后，单核细胞、CD34+ 33+或33-细胞以及CD34+ 38+细胞均与植入动力学无显著相关性。我们在此还证明，在一系列患有恶性疾病的患者中，与集落形成单位-粒细胞-巨噬细胞甚至总的CD34+细胞含量相比，CD34+ 38-细胞中的移植物含量在个体上是ABCT后最早以及最晚的三系造血恢复的更敏感指标。这表明CD34+ 38-细胞群体本身又细分为两个更多的亚群，一个已经确定了细胞系并负责短期植入，另一个仅包含负责持续植入的非常原始的造血细胞。有力的证据支持这些亚群分别对应HLA-DR+和DR细胞的可能性。我们还确定了一个最佳阈值，即每千克患者体重（b.w.）0.05×10⁶个CD34+ 38-细胞，高于此阈值则可安全地实现快速且持续的三系植入。事实上，与短期中性粒细胞恢复相比，输注数量较少的细胞似乎对长期有更显著的影响，并且对血小板动力学植入也有影响。我们还研究了疾病类型以及ABCT后造血生长因子（HGF）的给药对植入时间的最终影响。当疾病类型似乎对植入时间没有影响时，移植后给予HGF可显著缩短移植CD34+ 38-细胞数量<0.05×10⁶的患者的三系植入时间，因此在输注少量CD34+ 38-细胞进行回输的情况下是合理的。另一方面，在输注超过0.05×10⁶个CD34+ 38-细胞/kg b.w.后给予HGF，并不会更快地加速植入时间，或者仅能略微加速，因此这不仅对患者无益处，而且成本高昂。
