Stroncek David, Shawker Thomas, Follmann Dean, Leitman Susan F
Department of Transfusion Medicine, National Institutes of Health, Warren G. Magnuson Clinical Center, Building 10, Room 1C711, 10 Center Drive MSC-1184, Bethesda, MD 20892-1184, USA.
Transfusion. 2003 May;43(5):609-13. doi: 10.1046/j.1537-2995.2003.00384.x.
PBPC donors given G-CSF experience splenic enlargement and, rarely, spontaneous rupture of the spleen. This study evaluated the incidence and time course of splenic enlargement in PBPC concentrate donors and assessed factors affecting size changes.
Twenty healthy adults were given G-CSF (10 microg/kg/day) for 5 days and a PBPC concentrate was collected by apheresis. Ultrasound was used to assess craniocaudal spleen length before giving G-CSF, on the day of apheresis and 3 or 4 days after apheresis. The effects of donor age, gender, race, and changes in blood chemistries, blood counts, and CD34+ cell counts on spleen length change were assessed.
Spleen length increased in 19 of 20 donors. Mean length changed from 10.9 +/- 2.0 cm before G-CSF to 12.3 +/- 2.1 cm on the day of apheresis (p < 0.001). The mean increase in length was 1.5 +/- 0.9 cm or 13.8 +/- 9.1 percent. Spleen length increased 20 percent or more in six subjects. The spleen length fell to 11.3 +/- 1.8 cm (p < 0.001) 3 or 4 days after apheresis, but it remained greater than baseline levels (p = 0.03). Spleen length change was not affected by donor gender, race, or age. There was no relationship between changes in spleen length and 1) baseline and apheresis-day blood counts and chemistries, or 2) changes in blood counts and chemistries.
Spleen size increases in almost all PBPC donors. Enlargement is transient but may be marked in some donors and may place them at risk for splenic rupture.
接受粒细胞集落刺激因子（G-CSF）的外周血干细胞（PBPC）供者会出现脾脏肿大，脾脏自发性破裂则较为罕见。本研究评估了PBPC浓缩液供者脾脏肿大的发生率和时间进程，并分析了影响脾脏大小变化的因素。
20名健康成年人接受G-CSF（10微克/千克/天）治疗5天，然后通过血液成分单采术采集PBPC浓缩液。在给予G-CSF前、血液成分单采当天以及血液成分单采后3或4天，使用超声评估脾脏的头-尾长度。评估供者年龄、性别、种族以及血液化学指标、血细胞计数和CD34+细胞计数的变化对脾脏长度变化的影响。
20名供者中有19名脾脏长度增加。平均长度从给予G-CSF前的10.9±2.0厘米增加到血液成分单采当天的12.3±2.1厘米（p<0.001）。长度平均增加1.5±0.9厘米，即13.8±9.1%。6名受试者的脾脏长度增加了20%或更多。血液成分单采后3或4天，脾脏长度降至11.3±1.8厘米（p<0.001），但仍高于基线水平（p=0.03）。脾脏长度变化不受供者性别、种族或年龄的影响。脾脏长度变化与1）基线和血液成分单采当天的血细胞计数及血液化学指标，或2）血细胞计数和血液化学指标的变化之间均无关联。结论：几乎所有PBPC供者的脾脏大小都会增加。肿大是暂时的，但在一些供者中可能较为明显，这可能使他们面临脾脏破裂的风险。
