Goren Sahin Deniz, Arat Mutlu
Istanbul Bilim University Medical School, Department of Hematology, Istanbul, Turkey; Sisli Florence Nightingale Hospital, Stem Cell Transplantation Unit, Istanbul, Turkey.
Sisli Florence Nightingale Hospital, Stem Cell Transplantation Unit, Istanbul, Turkey.
Transfus Apher Sci. 2017 Dec;56(6):800-803. doi: 10.1016/j.transci.2017.11.009. Epub 2017 Nov 8.
Proper stem cell mobilization is one of the most important steps in hematopoietic stem cell transplantation (HSCT). The aim of this paper is to share our 6 years' experience and provide practical clinical approaches particularly for stem cell mobilization and collection within the series of more than 200 successive allogeneic HSCT at our transplant center.
SUBJECTS & METHODS: Two hundred and seven consecutive patients who underwent allogeneic peripheral blood stem cell transplantation were included in this study. Age, sex, weight, complete blood counts, CD34 cell counts, total collected amount of CD34 cells, CD34 cells per 10l processed, mobilization failure and adverse events were reviewed.
Median age was 40.2±12.9 (21-68) years and 46.4±13.4 (17-67) years for donors and patients, respectively. The number of donors who had undergone adequate CD34 cell harvesting and completed the procedure on the fourth day was 67 (32.8% of all patients). Only 12 patients required cell apheresis both on day 5 and 6. Apheresis was completed on day 4 and/or day 5 in 94.2% of all our donors. There was no significant association between CD34 stem cell volume and age, gender and weight values of donors. Mobilization failure was not seen in our series.
G-CSF is highly effective in 1/3 of the donors on the 4th day in order to collect enough number of stem cells. We propose that peripheral stem cell collection might start on day 4th of G-CSF treatment for avoiding G-CSF related side effects and complications.
适当的干细胞动员是造血干细胞移植(HSCT)中最重要的步骤之一。本文旨在分享我们6年的经验,并提供切实可行的临床方法,特别是针对我们移植中心连续200多例异基因HSCT系列中的干细胞动员和采集。
本研究纳入了207例连续接受异基因外周血干细胞移植的患者。回顾了年龄、性别、体重、全血细胞计数、CD34细胞计数、CD34细胞的总采集量、每升处理液中的CD34细胞数、动员失败情况和不良事件。
供者和患者的中位年龄分别为40.2±12.9(21 - 68)岁和46.4±13.4(17 - 67)岁。在第4天完成足够数量CD34细胞采集并完成操作的供者有67例(占所有患者的32.8%)。只有12例患者在第5天和第6天都需要进行细胞单采。94.2%的供者在第4天和/或第5天完成了单采。CD34干细胞体积与供者的年龄、性别和体重值之间无显著关联。我们的系列研究中未出现动员失败情况。
为了采集足够数量的干细胞,粒细胞集落刺激因子(G - CSF)在第4天对三分之一的供者非常有效。我们建议外周干细胞采集可在G - CSF治疗的第4天开始,以避免与G - CSF相关的副作用和并发症。