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外周血造血干细胞动员和采集的疗效和安全性:190 例异基因供者的单中心经验。

Efficacy and safety of peripheral blood stem cell mobilization and collection: a single-center experience in 190 allogeneic donors.

机构信息

Transfusion Medicine Department and the Clinic of Haematology, University Hospital of Udine, and the Department of Statistics, University of Udine, Udine, Italy.

出版信息

Transfusion. 2012 Nov;52(11):2387-94. doi: 10.1111/j.1537-2995.2012.03619.x. Epub 2012 Mar 27.

Abstract

BACKGROUND

In the past two decades peripheral blood stem cells (PBSCs) have increasingly replaced marrow as stem cells source for allogeneic transplantation. The PBSC donation initially applied only to related donors; later, due to the safety of the procedure, it was extended to unrelated donors.

STUDY DESIGN AND METHODS

We have retrospectively collected data regarding mobilization, collection, and short- and long-term follow-up of 190 consecutive donors, 174 related and 16 unrelated. All donors followed a standard protocol for mobilization and underwent at least one PBSC collection. Follow-up in related donors was performed every 4 months in the first year and then annually, with no time limits, while unrelated donors were monitored for 10 years.

RESULTS

All 190 donors completed the established mobilization protocol. The mobilizing capacity was significantly greater in males and in donors less than 60 years old. No case of major toxicity by granulocyte-colony-stimulating factor was found, nor thromboembolic events. The total dose of CD34+/recipient (median 5.8×10(6)/kg recipient/body weight) was statistically correlated with age, CD34+ before and after mobilization, and collection efficiency. Compliance to follow-up was 66%, with a significant difference between related and unrelated (63% vs. 100%, p=0.03). During follow-up no significant abnormalities in hematologic variables or hematologic malignancies were reported.

CONCLUSION

Our study allowed us to define the PBSC donation as "a safe procedure for the donors," with short- and long-term effects limited to a small percentage of donors and "effective for the recipient," due to the dose of collected CD34+, adequate for transplantation in almost all recipients.

摘要

背景

在过去的二十年中,外周血干细胞(PBSC)已逐渐取代骨髓成为异基因移植的干细胞来源。最初,PBSC 捐献仅适用于相关供者;后来,由于该程序的安全性,其范围扩大到了无关供者。

研究设计和方法

我们回顾性地收集了 190 名连续供者的动员、采集以及短期和长期随访数据,其中 174 名为相关供者,16 名为无关供者。所有供者均遵循标准的动员方案,并至少进行了一次 PBSC 采集。相关供者在第 1 年每 4 个月进行一次随访,然后每年进行一次随访,无时间限制,而无关供者则监测 10 年。

结果

所有 190 名供者均完成了既定的动员方案。男性和年龄小于 60 岁的供者动员能力明显更强。未发现粒细胞集落刺激因子的主要毒性或血栓栓塞事件。CD34+/受者的总剂量(中位数为 5.8×10(6)/kg 受者/体重)与年龄、动员前后的 CD34+以及采集效率呈统计学相关。随访依从性为 66%,相关供者和无关供者之间存在显著差异(63%与 100%,p=0.03)。在随访期间,未报告血液学变量或血液系统恶性肿瘤有任何显著异常。

结论

我们的研究使我们能够将 PBSC 捐献定义为“对供者安全的程序”,其短期和长期影响仅限于一小部分供者,并且“对受者有效”,因为采集的 CD34+量足以满足几乎所有受者的移植需求。

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