Gerhartz H
Med. Klinik III, Ludwig-Maximilian-Universität München.
Beitr Infusionsther. 1991;28:254-8.
Autologous bone marrow transplantation has gained an increasing role in modern oncology. The use of circulating progenitors from the peripheral blood as autografts might have some important advantages, since leukaphereses are better tolerable than a BM harvest, could be done immediately following chemotherapy, are possible in patients with previous irradiation to the pelvis and might be less contaminated with malignant progenitor cells. We have shown that monitoring transplants with the relatively simple in vitro assay for myeloid progenitor cells is predictive for hematopoietic recovery in animal models as well as in the clinical setting. Moreover, stem cells harvested during repeated leukapheresis were able to repopulate permanently the irradiated BM. Using recombinant human granulocyte/macrophage colony stimulating factor, large quantities of progenitor cells can be mobilized into the peripheral blood and collected for autotransplantation, in particular if used directly following chemotherapy. Cell separation studies showed that a bone marrow/blood barrier retains some subpopulations of progenitor cells which might lead to the preferential circulation of normal stem cells following chemotherapy. Methods are described to distinguish normal and leukemic progenitor cells which will help in the future to assay autografts both for their repopulating ability and their contamination with tumor cells.
自体骨髓移植在现代肿瘤学中发挥着越来越重要的作用。使用外周血中的循环祖细胞作为自体移植物可能具有一些重要优势，因为白细胞单采术比骨髓采集耐受性更好，可以在化疗后立即进行，对于先前接受过盆腔放疗的患者也可行，并且可能较少受到恶性祖细胞的污染。我们已经表明，使用相对简单的体外髓系祖细胞检测方法监测移植对动物模型以及临床环境中的造血恢复具有预测性。此外，在重复白细胞单采过程中采集的干细胞能够永久性地重新填充受照射的骨髓。使用重组人粒细胞/巨噬细胞集落刺激因子，可以将大量祖细胞动员到外周血中并收集用于自体移植，特别是在化疗后直接使用时。细胞分离研究表明，骨髓/血液屏障保留了一些祖细胞亚群，这可能导致化疗后正常干细胞的优先循环。文中描述了区分正常和白血病祖细胞的方法，这将有助于未来检测自体移植物的再填充能力及其肿瘤细胞污染情况。
