Moss T J, Sanders D G, Lasky L C, Bostrom B
Ahmanson Pediatric Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Blood. 1990 Nov 1;76(9):1879-83.
Peripheral blood stem cells (PBSC) are being used as one alternative to autologous marrow rescue for patients with neuroblastoma and other solid malignancies. Some physicians prefer use of PBSC because less risk of tumor contamination is believed to exist. This hypothesis was evaluated by immunocytologic analysis of blood samples and concurrently drawn bone marrow (BM) samples and of PBSC harvests obtained from 31 patients with disseminated neuroblastoma. We found circulating neoplastic cells in 75% of specimens analyzed at diagnosis, in 36% during therapy, and in 14% of PBSC harvests. Tumor cells in blood obtained during therapy did not appear until 3 months after the time of diagnosis. Clearance of circulating neuroblastoma cells was documented after two courses of induction chemotherapy. Six of 13 patients with minimal or no BM disease had positive blood specimens. We conclude that substantial risk of tumor contamination of PB harvests exists and recommend that induction chemotherapy be administered before hematopoietic progenitor cells are collected from blood.
外周血干细胞（PBSC）正被用作神经母细胞瘤和其他实体恶性肿瘤患者自体骨髓挽救的一种替代方法。一些医生倾向于使用PBSC，因为据信肿瘤污染风险较低。通过对31例播散性神经母细胞瘤患者的血样、同时采集的骨髓（BM）样本以及PBSC采集物进行免疫细胞分析，对这一假设进行了评估。我们发现，在诊断时分析的标本中，75%存在循环肿瘤细胞，治疗期间为36%，PBSC采集物中为14%。治疗期间采集的血液中的肿瘤细胞直到诊断后3个月才出现。两个疗程的诱导化疗后记录到循环神经母细胞瘤细胞清除。13例骨髓疾病轻微或无骨髓疾病的患者中有6例血标本呈阳性。我们得出结论，PB采集物存在肿瘤污染的重大风险，并建议在从血液中采集造血祖细胞之前进行诱导化疗。
