Li Yan, Chang Yingjun, Xu Lanping, Zhang Xiaohui, Huang Xiaojun
Peking University Institute of Hematology, Peking University People's Hospital, Beijing 100044, China.
Peking University Institute of Hematology, Peking University People's Hospital, Beijing 100044, China. Email:
Chin Med J (Engl). 2014;127(20):3597-601.
The effects of donor characteristics on CD34(+) cell dose remain controversial. Recently, we developed a novel haploidentical transplant protocol, in which mixture allografts of granulocyte colony-stimulating factor (G-CSF)-primed bone marrow (G-BM) and G-CSF-mobilized peripheral blood (G-PB) were used. The aim of this study was to investigate the effects of donor characteristics on CD34(+) cell dose in mixture allografts of G-BM and G-PB.
A total of 162 healthy adult donors, who underwent bone marrow harvest and peripheral blood collection between January 2009 and November 2010 in Peking University People's Hospital, were prospectively investigated. G-CSF was administered subcutaneously at a dose of 5 µg/kg once a day for 5-6 consecutive days. Bone marrow and peripheral blood stem cells were harvested on the fourth day and fifth day, respectively. A final total CD34(+) cell dose less than 2×10(6) cells/kg recipient body weight was considered a poor mobilization.
Of the 162 donors, 31 (19.1%) did not attain this threshold. The obtained median CD34(+) cell doses in bone marrow, peripheral blood, and mixture allografts were 0.83×10(6)/kg, 2.40×10(6)/kg, and 3.47×10(6)/kg, respectively. Multiple regression analysis showed that donor age had a significant negative effect on CD34(+) cell dose in either G-BM, or G-PB, or mixture allografts of G-BM and G-PB. And a 1-year increase in age was associated with a 5.6% decrease in the odds of achieving mobilization cutoff. No significant correlation was found for donor gender, body mass index (BMI), and weight.
Donor age is the only factor among the four parameters, including age, gender, weight, and BMI, that influence CD34(+) cell dose in mixture allografts of G-BM and G-PB, and younger donors should be chosen to obtain sufficient CD34(+) cells for transplantation.
供体特征对CD34(+)细胞剂量的影响仍存在争议。最近,我们开发了一种新型单倍体移植方案,其中使用粒细胞集落刺激因子(G-CSF)预处理的骨髓(G-BM)和G-CSF动员的外周血(G-PB)的混合同种异体移植物。本研究的目的是探讨供体特征对G-BM和G-PB混合同种异体移植物中CD34(+)细胞剂量的影响。
对2009年1月至2010年11月期间在北京大学人民医院接受骨髓采集和外周血采集的162名健康成年供体进行前瞻性研究。G-CSF以5μg/kg的剂量皮下注射,每天1次,连续5 - 6天。分别在第4天和第5天采集骨髓和外周血干细胞。最终总CD34(+)细胞剂量低于2×10(6)个细胞/kg受者体重被认为动员效果不佳。
在162名供体中,31名(19.1%)未达到该阈值。骨髓、外周血和混合同种异体移植物中获得的CD34(+)细胞剂量中位数分别为0.83×10(6)/kg、2.40×10(6)/kg和3.47×10(6)/kg。多元回归分析显示,供体年龄对G-BM、G-PB或G-BM与G-PB的混合同种异体移植物中的CD34(+)细胞剂量有显著负面影响。年龄每增加1岁,达到动员临界值的几率降低5.6%。未发现供体性别、体重指数(BMI)和体重有显著相关性。
在年龄、性别、体重和BMI这四个参数中,供体年龄是影响G-BM和G-PB混合同种异体移植物中CD34(+)细胞剂量的唯一因素,应选择年轻供体以获得足够的CD34(+)细胞用于移植。