Xu Wei, Zhu Mei, Li Yan-Ping, Bian Mao-Hong, Wei Yu-Zhi, Xia Xue, Zhang Xun-Shan
Department of Blood Transfusion, Anhui Medical University First Hospital, Hefei, Anhui Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2011 Oct;19(5):1237-40.
The study was aimed to evaluate the yield of the COBE Spectra blood cell separator with auto-peripheral blood stem cell program for collection of peripheral blood hematopoietic stem cells (PBHSC) from HLA-matched ABO-incompatible allogeneic PBHSC donor, and observe the safety and effect of allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBHSCT) without removal of erythrocytes and plasma. PBHSC from 28 allogeneic donors were collected by COBE Spectra blood cell separator with auto-peripheral blood hematopoiEtic stem cell (auto-PBHSCT) program. Control group included 15 HLA-matched patients who received allo-PBHSCT with ABO-compatible grafts. The amount of PBHSC was harvested and the parameter was modified according to the hematocrit and mononuclear cell (MNC) counts of donors. The nucleated cell count, proportion of MNC, number of CD34(+) cells were detected, and reconstitution status of hematopoietic function and time for change into donor's blood group were observed. The results showed that the nucleated cell count proportion of MNC and number of CD34(+) cells showed no significant difference between groups of ABO incompatible and compatible (p > 0.05). All their hematopoietic functions were reconstituted. Between the ABO incompatibility and the compatible groups, the time of neutrophil and platelet recovery was not significantly different (p > 0.05), In ABO blood major incompatible and the compatible groups, the recovery of erythropoiesis were significantly delayed (p < 0.01). The blood type of 18 patients in ABO incompatible group was turned into donor's blood type successfully at 35-139 days after transplantation. It is concluded that major ABO incompatibility did not affect the erythropoiesis reconstitution in HLA matched allo-HSCT. the major incompatibility may be a main reason of erythropoietic delay.
本研究旨在评估采用自动外周血干细胞程序的COBE Spectra血细胞分离机从HLA匹配但ABO血型不相合的异基因外周血造血干细胞（PBHSC）供者采集外周血造血干细胞（PBHSC）的产量，并观察不去除红细胞和血浆的异基因外周血造血干细胞移植（allo-PBHSCT）的安全性和效果。采用COBE Spectra血细胞分离机的自动外周血造血干细胞（auto-PBHSCT）程序从28例异基因供者采集PBHSC。对照组包括15例接受ABO血型相合移植物的HLA匹配患者，接受allo-PBHSCT。根据供者的血细胞比容和单核细胞（MNC）计数采集PBHSC并调整参数。检测有核细胞计数、MNC比例、CD34(+)细胞数量，观察造血功能重建情况及血型转变为供者血型的时间。结果显示，ABO血型不相合组与相合组之间的有核细胞计数、MNC比例和CD34(+)细胞数量差异无统计学意义（p>0.05）。所有患者的造血功能均得以重建。ABO血型不相合组与相合组之间，中性粒细胞和血小板恢复时间差异无统计学意义（p>0.05）；ABO血型主要不相合组与相合组之间，红细胞生成恢复明显延迟（p<0.01）。ABO血型不相合组18例患者在移植后35~139天成功转变为供者血型。结论：ABO血型主要不相合不影响HLA匹配的异基因造血干细胞移植中的红细胞生成重建，主要不相合可能是红细胞生成延迟的主要原因。
