Demirer T, Ilhan O, Arat M, Genç Y, Ozcan M, Dalva K, Celebi H, Beksaç M, Akan H, Gürman G, Konuk N, Uysal A, Arslan O, Koç H
Department of Hematology and Bone Marrow Transplantation Unit, Ankara University Medical School, Ibn-i Sina Hospital, Sihhiye, Ankara, Turkey.
J Clin Apher. 2001;16(2):67-73. doi: 10.1002/jca.1015.
The objective of this study was to quantify subpopulations of CD34+ cells such as CD41+ and CD42+ cells that might represent megakaryocyte (MK) precursors in peripheral blood stem cell (PBSC) collections of normal, recombinant human granulocyte-colony stimulating factor (rhG-CSF) primed donors and to determine whether there is a statistical association between the dose infused megakaryocytic precursors and the time course of the platelet recovery following an allogeneic PBSC transplantation. Twenty-six patients with various hematologic malignancies transplanted from their HLA identical siblings between July 1997 and December 1999 were used. All patients except one with severe aplastic anemia who had cyclophosphamide (CY) alone received busulfan-CY as preparative regimen and cyclosporine-methotrexate for GVHD prophylaxis. Normal healthy donors were given rhG-CSF 10 microg/kg/day subcutaneously twice daily and PBSCs were collected on days 5 and 6. The median number of infused CD34+, CD41+ and CD42+ cells were 6.61 x 10(6)/kg (range 1.47-21.41), 54.85 x 10(4)/kg (5.38-204.19), and 49.86 x 10(4)/kg (6.82-430.10), respectively. Median days of ANC 0.5 x 10(9)/L and platelet 20 x 10(9)/L were 11.5 (range 9-15) and 13 (8-33), respectively. In this study, the number of CD41+ and CD42+ cells infused much better correlated than the number of CD34+ cells infused with the time to platelet recovery of 20 x 10(9)/L in 26 patients receiving an allogeneic match sibling PBSC transplantation (r = -0.727 and P < 0.001 for CD41+ cells, r = -0.806 and P < 0.001 for CD42+ cells, r = -0.336 and P > 0.05 for CD34+ cells). There was an inverse correlation between the number of infused CD41+ and CD42+ cells and duration of platelet engraftment. Therefore, as the number of CD41+ and CD42+ cells increased, duration of platelet engraftment (time to reach platelet count of > or = 20 x 10(9)/L) shortened significantly. Based on this data we may conclude that flow cytometric measurement of CD41+ and CD42+ progenitor cells may provide an accurate indication of platelet reconstitutive capacity of the allogeneic PBSC transplant.
本研究的目的是对正常供者、重组人粒细胞集落刺激因子（rhG-CSF）动员的外周血干细胞（PBSC）采集中可能代表巨核细胞（MK）前体的CD34+细胞亚群（如CD41+和CD42+细胞）进行定量，并确定输注的巨核细胞前体剂量与异基因PBSC移植后血小板恢复的时间进程之间是否存在统计学关联。研究使用了1997年7月至1999年12月间从其HLA配型相同的同胞处接受移植的26例各种血液系统恶性肿瘤患者。除1例严重再生障碍性贫血患者仅接受环磷酰胺（CY）治疗外，所有患者均接受白消安-CY作为预处理方案，并使用环孢素-甲氨蝶呤预防移植物抗宿主病（GVHD）。正常健康供者皮下注射rhG-CSF 10μg/kg/天，每日2次，在第5天和第6天采集PBSC。输注的CD34+、CD41+和CD42+细胞的中位数分别为6.61×10⁶/kg（范围1.47 - 21.41）、54.85×10⁴/kg（5.38 - 204.19）和49.86×10⁴/kg（6.82 - 430.10）。中性粒细胞计数达到0.5×10⁹/L和血小板计数达到20×10⁹/L的中位天数分别为11.5天（范围9 - 15天）和13天（8 - 33天）。在本研究中，接受异基因匹配同胞PBSC移植的26例患者中，输注的CD41+和CD42+细胞数量与血小板恢复至计数20×10⁹/L的时间的相关性，比输注的CD34+细胞数量与该时间的相关性更好（CD41+细胞：r = -0.727，P < 0.001；CD42+细胞：r = -0.806，P < 0.001；CD34+细胞：r = -0.336，P > 0.05）。输注的CD41+和CD42+细胞数量与血小板植入持续时间呈负相关。因此，随着CD41+和CD42+细胞数量增加，血小板植入持续时间（达到血小板计数≥20×10⁹/L的时间）显著缩短。基于这些数据我们可以得出结论，流式细胞术检测CD41+和CD42+祖细胞可能为异基因PBSC移植的血小板重建能力提供准确指标。
