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[为支持高剂量化疗进行自体移植,针对不同肿瘤性疾病儿童的造血干细胞动员与采集(单中心经验)]

[Mobilization and collection of hematopoietic stem cells in children with different neoplastic diseases for autotransplantation to support high dose chemotherapy (single centre experience)].

作者信息

Goździk Jolanta, Czogała Wojciech, Skoczeń Szymon, Krasowska-Kwiecień Aleksandra, Wiecha Oktawiusz, Stec Małgorzata, Czogała Małgorzata

机构信息

Ośrodek Transplantacji Uniwersyteckiego Szpitala Dzieciecego w Krakowie.

出版信息

Przegl Lek. 2011;68(4):185-90.

Abstract

Currently, granulocyte colony stimulating factor (G-CSF) alone or in combination with myelosuppresive chemotherapy remain the standards of CD34+ cells mobilization allows the safe and successful collection of adequate peripheral blood stem cells (PBSC) for autologous transplantation. However, in up to 30% of patients mobilization of PBSC is ineffective. This report presents our experience in mobilization and collection of peripheral blood stem cells in 82 children with different proliferative disease. In mobilization G-CSF was administered alone in steady state (56 patients, pts) or in combination with myelosuppresive chemotherapy (26 pts). The CD34+ cell count at least 10 cells/ml was required to start apheresis procedure, which was repeated, if needed, during following 1-4 days until collection of at least 2 (optimally 3) x106 CD34+ cells/kg b.w. of recipient was obtained. Three pts in each group (3/ 56 and 3/26) failed the first course of mobilization. The median number of CD34+ cells mobilized was 4.8 (0.5-15) x106/kg b.w. The minimal and optimal number of CD34+ cells for transplantation was achieved in 85% and 61% of patients in the G-CSF + chemotherapy group and in 84% and 54% in the G-CSF group, respectively. The efficacy of presented mobilization arms in our group was similar. However, the incidence of infection and total hospitalization time during mobilization were higher in chemotherapy + G-CSF group.

摘要

目前,单独使用粒细胞集落刺激因子(G-CSF)或与骨髓抑制性化疗联合使用仍是动员CD34+细胞的标准方法,这使得能够安全、成功地采集足够的外周血干细胞(PBSC)用于自体移植。然而,高达30%的患者外周血干细胞动员无效。本报告介绍了我们在82例患有不同增殖性疾病的儿童中动员和采集外周血干细胞的经验。在动员过程中,G-CSF单独以稳态方式给药(56例患者)或与骨髓抑制性化疗联合使用(26例患者)。开始单采程序要求CD34+细胞计数至少为10个/毫升,如果需要,在接下来的1-4天内重复进行,直到获得至少2(最佳为3)×10⁶个CD34+细胞/千克受者体重。每组各有3例患者(3/56和3/26)首次动员疗程失败。动员的CD34+细胞中位数为4.8(0.5-15)×10⁶/千克体重。在G-CSF+化疗组中,分别有85%和61%的患者达到了移植所需的最低和最佳CD34+细胞数量;在G-CSF组中,这一比例分别为84%和54%。我们组中所采用的动员方案的疗效相似。然而,化疗+G-CSF组在动员期间的感染发生率和总住院时间更高。

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