Shimazaki C, Oku N, Ashihara E, Okawa K, Goto H, Inaba T, Ito K, Fujita N, Tsuji H, Murakami S
Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan.
Bone Marrow Transplant. 1992 Oct;10(4):341-6.
We developed an effective method for harvesting large numbers of peripheral blood stem cells (PBSC) for use in autotransplantation. Twenty patients with hematological malignancies were treated with high doses of Ara-C (12 g/m2) and VP-16/aclarubicin followed by administration of rhG-CSF (50 micrograms/m2). The optimal time for starting PBSC collection was determined by monitoring the CD34-positive stem cells in blood using immunomagnetic beads. PBSC were collected with a CS-3000 blood cell separator. A total blood volume between 7000 and 9000 ml was processed in each apheresis. Under these conditions, a total of 64 apheresis procedures was performed in the 20 patients. The mean numbers of mononuclear cells and of CFU-GM harvested per apheresis were 4.1 x 10(8)/kg and 110 x 10(4)/kg, respectively. A number of CFU-GM sufficient for engraftment (> 30 x 10(4)/kg) could be harvested by a single apheresis in 15 of the 20 patients. So far, 11 patients have been transplanted with PBSC and obtained rapid hematopoietic recovery. The median time to recover neutrophils more than 0.5 x 10(9)/l was 10 days, and that for platelets 50 x 10(9)/l was 11 days. This method for harvesting large numbers of PBSC allows safer autotransplantation in patients with chemoradiosensitive tumors, and is applicable to older patients.
我们开发了一种有效的方法来采集大量外周血干细胞（PBSC）用于自体移植。20例血液系统恶性肿瘤患者接受了大剂量阿糖胞苷（12 g/m²）和依托泊苷/阿克拉霉素治疗，随后给予重组人粒细胞集落刺激因子（rhG-CSF，50微克/m²）。通过使用免疫磁珠监测血液中CD34阳性干细胞来确定开始采集PBSC的最佳时间。使用CS-3000血细胞分离机采集PBSC。每次单采过程中处理的全血体积为7000至9000毫升。在这些条件下，20例患者共进行了64次单采程序。每次单采收获的单个核细胞和CFU-GM的平均数量分别为4.1×10⁸/kg和110×10⁴/kg。20例患者中有15例通过单次单采即可收获足以实现植入的CFU-GM数量（>30×10⁴/kg）。到目前为止，11例患者已接受PBSC移植并实现了快速造血恢复。中性粒细胞恢复至超过0.5×10⁹/L的中位时间为10天，血小板恢复至50×10⁹/L的中位时间为11天。这种采集大量PBSC的方法可使放化疗敏感肿瘤患者进行更安全的自体移植，并且适用于老年患者。
