Servicio de Hematología, Hospital Universitario Dr José E. González, Facultad de Medicina de la Universidad Autónoma Nuevo León, Monterrey, NL, México.
Transfusion. 2009 Nov;49(11):2390-4. doi: 10.1111/j.1537-2995.2009.02292.x.
Infusion of an adequate dose of CD34+ mononuclear hematopoietic stem cells (HSCs) is the single most important variable to assure success in hematopoietic grafting. CD133+ HSCs constitute the CD34+ subgroup with higher differentiation potential. The number of granulocyte-colony-stimulating factor (G-CSF)-mobilized CD133+ HSCs administered during hematopoietic grafting and its relationship with the number of days needed to regain hematopoiesis was determined.
Thirty-eight patients with malignant hematologic diseases who received an autologous (n = 15) or allogeneic (n = 23) HSC transplant were prospectively evaluated. G-CSF was administered for 5 days at 10 microg/kg/day. Hematopoietic progenitors were recovered from peripheral blood on day 5 by leukopheresis. CD34+ and CD133+/CD34+ cell populations were quantified by flow cytometry; the number of days to hematologic recovery was documented.
A median dose of 4.56 x 10(6)/kg CD34+ HSCs (range, 1.35 x 10(6)-14.6 x 10(6)) was recovered and transplanted; of these grafted cells, a median 3.25 x 10(6) were also CD133+ (range, 1.25 x 10(6)-14.3 x 10(6)). In the autologous group, the median number of days to reach a platelet (PLT) count of 20 x 10(9)/L or greater was 12, and 15 days to obtain a neutrophil count of 0.5 x 10(9)/L or greater; in the allogeneic group 13 and 16 days, respectively, were required (p > 0.05). A median 76.5% of G-CSF-mobilized CD34+ HSCs coexpressed the CD133+ antigen (range, 23.1-97.9).
A higher number of CD133+/CD34+ HSCs in the graft was not clearly associated with a shorter neutrophil or PLT recovery time in either allogeneic or autologous recipients.
输注足够剂量的 CD34+ 单核造血干细胞(HSCs)是保证造血移植成功的唯一最重要的变量。CD133+HSCs 构成 CD34+ 亚群,具有更高的分化潜能。本文确定了在造血移植过程中输注的粒细胞集落刺激因子(G-CSF)动员的 CD133+HSCs 的数量及其与恢复造血所需天数之间的关系。
38 例患有恶性血液病的患者接受了自体(n=15)或同种异体(n=23)HSC 移植,前瞻性评估。每天给予 10μg/kg 的 G-CSF,连续 5 天。第 5 天通过白细胞去除术从外周血中回收造血祖细胞。通过流式细胞术定量检测 CD34+和 CD133+/CD34+细胞群;记录血液学恢复的天数。
回收并移植的 CD34+HSCs 的中位数剂量为 4.56×106/kg(范围为 1.35×106-14.6×106);其中移植细胞的中位数为 3.25×106 也是 CD133+(范围为 1.25×106-14.3×106)。在自体组中,血小板(PLT)计数达到 20×109/L 或更高的中位数时间为 12 天,中性粒细胞计数达到 0.5×109/L 或更高的中位数时间为 15 天;在同种异体组中,分别需要 13 天和 16 天(p>0.05)。动员的 CD34+HSCs 中有中位数 76.5%共同表达 CD133+抗原(范围为 23.1-97.9)。
同种异体或自体受者中,移植物中 CD133+/CD34+HSCs 的数量增加与中性粒细胞或 PLT 恢复时间的缩短没有明显关系。