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在未处理的人类白细胞抗原单倍型相同/不匹配的亲属移植中,联合使用粒细胞集落刺激因子动员的血液和骨髓进行干细胞采集,用于治疗血液系统恶性肿瘤患者:供体特征和操作设置的影响

Stem cell collection in unmanipulated HLA-haploidentical/mismatched related transplantation with combined granulocyte-colony stimulating factor-mobilised blood and bone marrow for patients with haematologic malignancies: the impact of donor characteristics and procedural settings.

作者信息

Zhang C, Chen X-H, Zhang X, Gao L, Gao L, Kong P-Y, Peng X-G, Sun A-H, Gong Y, Zeng D-F, Wang Q-Y

机构信息

Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing, People's Republic of China.

出版信息

Transfus Med. 2010 Jun;20(3):169-77. doi: 10.1111/j.1365-3148.2010.00990.x. Epub 2010 Feb 1.

Abstract

Unmanipulated haploidentical/mismatched related transplantation with combined granulocyte-colony stimulating factor-mobilised peripheral blood stem cells (G-PBSCs) and granulocyte-colony stimulating factor-mobilised bone marrow (G-BM) has been developed as an alternative transplantation strategy for patients with haematologic malignancies. However, little information is available about the factors predicting the outcome of peripheral blood stem cell (PBSC) collection and bone marrow (BM) harvest in this transplantation. The effects of donor characteristics and procedure factors on CD34(+) cell yield were investigated. A total of 104 related healthy donors received granulocyte-colony stimulating factor (G-CSF) followed by PBSC collection and BM harvest. Male donors had significantly higher yields compared with female donors. In multiple regression analysis for peripheral blood collection, age and flow rate were negatively correlated with cell yield, whereas body mass index, pre-aphaeresis white blood cell (WBC) and circulating immature cell (CIC) counts were positively correlated with cell yields. For BM harvest, age was negatively correlated with cell yields, whereas pre-BM collection CIC counts were positively correlated with cell yield. All donors achieved the final product of >or=6 x10(6) kg(-1) recipient body weight. This transplantation strategy has been shown to be a feasible approach with acceptable outcomes in stem cell collection for patients who received HLA-haploidentical/mismatched transplantation with combined G-PBSCs and G-BM. In donors with multiple high-risk characteristics for poor aphaeresis CD34(+) cell yield, BM was an alternative source.

摘要

将粒细胞集落刺激因子动员的外周血干细胞(G-PBSCs)与粒细胞集落刺激因子动员的骨髓(G-BM)联合进行未处理的单倍体相合/不相合相关移植,已被开发为血液系统恶性肿瘤患者的一种替代移植策略。然而,关于预测这种移植中外周血干细胞(PBSC)采集和骨髓(BM)收获结果的因素,目前所知甚少。研究了供体特征和操作因素对CD34(+)细胞产量的影响。共有104名相关健康供体接受了粒细胞集落刺激因子(G-CSF)治疗,随后进行了PBSC采集和BM收获。男性供体的产量显著高于女性供体。在外周血采集的多元回归分析中,年龄和流速与细胞产量呈负相关,而体重指数、单采前白细胞(WBC)和循环未成熟细胞(CIC)计数与细胞产量呈正相关。对于BM收获,年龄与细胞产量呈负相关,而BM采集前CIC计数与细胞产量呈正相关。所有供体均获得了≥6×10(6) kg(-1)受体体重的最终产品。对于接受G-PBSCs和G-BM联合的HLA单倍体相合/不相合移植的患者,这种移植策略已被证明是一种可行的方法,在干细胞采集中具有可接受的结果。对于单采CD34(+)细胞产量不佳具有多种高风险特征的供体,BM是一种替代来源。

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