Liu Hua-Sheng, Wang Xiao-Ning, Liu Hai-Bo, Liu Xin, He Peng-Cheng, Chen Li-Mei, Xi Jie-Ying, Wang Meng-Chang, Li Jin, Zhang Hai-Tao, Zhang Mei
Department of Hematology, The First Affiliated Hospital of Xi'an JiaoTong University, Xi'an 710061, Shaanxi Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Oct;21(5):1232-6. doi: 10.7534/j.issn.1009-2137.2013.05.030.
This study was aimed to investigate the effects of different mobilization methods on mobilization and collection of peripheral blood stem cells in healthy donors and the adverse effect of collection, as well as hematopoietic construction in recipients. A total of 43 donors between January 2008 and May 2013 were divided into the simple mobilization group and the combined mobilization group. The simple group was subcutaneously injected with 5.0-10.0 µg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF), and the combined mobilization group was treated with rhG-CSF and intravenously dripped with 10 mg dexamethasone for 2-4 hours before collection. The acquisition and count of MNC and CD34(+) cells in different groups, the relationship between the stem cells and MNC count in blood before collection, and the adverse reactions were analyzed; the hematopoietic reconstruction of recipients was investigated. The results showed that the hematopoietic stem cell number of the two groups meet the demands. The count of MNC and CD34(+) cells in the simple mobilization group was more than that in the combined mobilization group. The MNC count in two groups positively correlated with peripheral blood MNC count before collection. The decline of hemoglobin and platelet levels was more obvious in the simple mobilization group than that in combined mobilization group. The adverse reactions of collection in the simple mobilization group could be well tolerated and reversed. There was no adverse reaction in the combined mobilization group. The differences of conditioning regimens between two groups were not statistically significant and the hematopoietic reconstruction time of combined group was shorter than that in the simple mobilization group.It is concluded that the adverse reactions in process of collection can be reduced, and enough hematopoietic stem cells can be collected by G-CSF plus dexamethasone in mobilization of peripheral blood stem cells. The count of MNC in peripheral blood before collection can be still used as a reference index to evaluate the acquisition of MNC. Especially the combination with dexamethasone for stem cell mobilization can promote the hematopoietic reconstruction of the recipients.
本研究旨在探讨不同动员方法对健康供者外周血干细胞动员采集的效果及采集的不良反应，以及对受者造血重建的影响。选取2008年1月至2013年5月间的43例供者，分为单纯动员组和联合动员组。单纯组皮下注射重组人粒细胞集落刺激因子（rhG-CSF）5.0 - 10.0 μg/(kg·d)，联合动员组在采集前用rhG-CSF并静脉滴注10 mg地塞米松2 - 4小时。分析不同组MNC和CD34(+)细胞的获取及计数、采集前血液中干细胞与MNC计数的关系以及不良反应；观察受者的造血重建情况。结果显示，两组造血干细胞数量均满足需求。单纯动员组MNC和CD34(+)细胞计数高于联合动员组。两组MNC计数与采集前外周血MNC计数呈正相关。单纯动员组血红蛋白和血小板水平下降较联合动员组更明显。单纯动员组采集的不良反应可耐受且可恢复。联合动员组无不良反应。两组预处理方案差异无统计学意义，联合组造血重建时间短于单纯动员组。结论：在动员外周血干细胞过程中，G-CSF加地塞米松可减少采集过程中的不良反应，采集到足够的造血干细胞。采集前外周血MNC计数仍可作为评估MNC获取的参考指标。特别是地塞米松联合用于干细胞动员可促进受者造血重建。
