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[低温冰箱至液氮阶梯式冷冻保存造血干细胞自体移植的临床疗效]

[Clinical Efficacy of Autologous Transplantation of Hematopoietic Stem Cells Cryopreserved by Ladder-style Freezing from Low Temperature Refrigerator to Liquid Nitrogen].

作者信息

Hu Peng, Yang Tong-Hua, Zhao Ren-Bin, Shi Ke-Qian, Yang Yan-Mei, Lai Xun

机构信息

Department of Hematology, The First People's Hospital of Yunnan Province, Kunming, 650032, Yunnan Praince, China.

Department of Hematology, The First People's Hospital of Yunnan Province, Kunming, 650032, Yunnan Praince, China.E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018 Oct;26(5):1507-1514. doi: 10.7534/j.issn.1009-2137.2018.05.042.

DOI:10.7534/j.issn.1009-2137.2018.05.042
PMID:30295276
Abstract

OBJECTIVE

To investigate the efficacy of hematopoietic stem cells cryopreserved by ladder-style freezing from low temperature refrigerator to liquid nitrogen in treatment of hematological malignancies, and to analyze the survival condition of patients after hematopoietic stem cell transplantation.

METHODS

The coyoprotectant formed by 3% hydroxyethyl starch, 4% albumin and 5% dimethyl sulfoxide (DMSO) was need for cryopreservation of hematopoietic stem cells,which were first placed in -80C low temperature refrigerator and then were stored in -196C liquid nitrogen tank. 98 cases of hemafologic malignancies (io cases of ALL, 24 cases of AML, L-cases of MM and 53 case of malignant lymphoma) were selected from January 2002 to December 2016, and recived transplantatin auto-hematopoiehc stem cells cryopresorved by above-mentined method. The overall survival rate (OS), progression-free survival (PFS) were analyzed statistically.

RESULTS

One case failed in implantation due to intracranial hemorrhage and the other 97 cases all succeeded in hematopoietic reconstitution. The average time needed for neutrophil count ≥0.5×10/L was 9.24±1.89 d, and the average time needed for blood platelet ≥20×10/L without platelet transfusion for 3 days was 11.04±1.84 d. The median survival time was 47.6 months (1-80 months). The 3 and 5 year OS rates were (97.2±1.9) %, (84.2±4.6) % and (77.8±5.6) %, respectively. 3- and 5-year PFS of patients were (74.4±5.1)% and (61.2±6.2)%.

CONCLUSION

ladder-style freezing from low temperature refrigerator to liquid nitrogen can reach the same clinical transplantation effect with traditional programmed cooling freezing method in autologous hematopoietic stem cells transplantation. moreover the incidence of complications after transpeantatim does not show increase.

摘要

目的

探讨经低温冰箱至液氮阶梯式冷冻保存的造血干细胞治疗血液系统恶性肿瘤的疗效,并分析造血干细胞移植后患者的生存情况。

方法

采用3%羟乙基淀粉、4%白蛋白和5%二甲基亚砜(DMSO)配制的冻存保护剂对造血干细胞进行冻存,先置于-80℃低温冰箱,再转入-196℃液氮罐保存。选取2002年1月至2016年12月收治的98例血液系统恶性肿瘤患者(急性淋巴细胞白血病10例、急性髓系白血病24例、多发性骨髓瘤11例、恶性淋巴瘤53例),接受上述方法冻存的自体造血干细胞移植。对总生存率(OS)、无进展生存期(PFS)进行统计学分析。

结果

1例因颅内出血植入失败,其余97例均造血重建成功。中性粒细胞计数≥0.5×10⁹/L平均所需时间为9.24±1.89天,血小板≥20×10⁹/L且无需输注血小板3天以上平均所需时间为11.04±1.84天。中位生存时间为47.6个月(1-80个月)。3年和5年总生存率分别为(97.2±1.9)%、(84.2±4.6)%和(77.8±5.6)%。患者3年和5年无进展生存率分别为(74.4±5.1)%和(61.2±6.2)%。

结论

低温冰箱至液氮阶梯式冷冻在自体造血干细胞移植中可达到与传统程序降温冷冻法相同的临床移植效果,且移植后并发症发生率未增加。

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