Bojanić Ines, Mazić Sanja, Cepulić Branka Golubić
Zavod za transfuzijsku medicinu i stanicnu terapiju, Klinicki bolnicki centar Zagreb, Kispatićeva 12, 10000 Zagreb.
Lijec Vjesn. 2009 Nov-Dec;131(11-12):315-23.
Summary. Peripheral blood hematopoietic stem cells (PBSC) have numerous advatages in comparison with traditionally used bone marrow. PBSC collection by leukapheresis procedure is simpler and better tolerated than bone marrow harvest. PBCS are mobilized by myelosupressive chemotherapy or/and hematopoietic growth factors. Leukapheresis product contains PBSC along with lineage commited progenitors and precursors which contribute to faster hematopoietic recovery. In "poor mobilizers" options are large-volume leukapheresis (LVL) procedure or second generation of mobilising agents (pegfilgrastim, CXCR4 receptor antagonists). Total blood volume is processed 2-3 times in standard procedure compared to more than 3 times in LVL. LVL yields significantly higher numbers of CD34+ cells. Adverse effects of leukapheresis are electrolyte disbalance (hypocalcemia) caused by citrat administration and risk of bleeding due to trobocytopenia and heparin administration. PBSC collection and product quality control are regulated by national and international standards and recommendations.
摘要。与传统使用的骨髓相比，外周血造血干细胞（PBSC）有诸多优势。通过白细胞单采术采集PBSC比采集骨髓更简单，耐受性更好。PBSC可通过骨髓抑制性化疗或/和造血生长因子动员。白细胞单采产物包含PBSC以及定向祖细胞和前体细胞，这有助于更快的造血恢复。对于“动员不佳者”，可选择大容量白细胞单采（LVL）程序或第二代动员剂（聚乙二醇化非格司亭、CXCR4受体拮抗剂）。在标准程序中，全血体积处理2 - 3次，而LVL则超过3次。LVL产生的CD34 +细胞数量显著更高。白细胞单采的不良反应是枸橼酸盐给药引起的电解质失衡（低钙血症）以及由于血小板减少和肝素给药导致的出血风险。PBSC采集和产物质量控制受国家和国际标准及建议的规范。
