Weaver C H, Longin K, Buckner C D, Bensinger W
Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
Bone Marrow Transplant. 1994 Apr;13(4):411-5.
The effects of rhG-CSF on peripheral blood lymphocytes and lymphocyte populations in the apheresis product has been determined in 13 individuals (11 autografts and 2 normal donors) who had peripheral blood mononuclear cells (PBMCs) collected on days 3, 4, and 5 of administration of rhG-CSF 16 micrograms/kg/day x 5 days. The absolute number of CD34+ cells increased 9 and 25-fold from pretreatment levels after 4 and 5 days of rhG-CSF, respectively. All patients demonstrated an increase in CD3, CD4, CD8, CD19 and CD20 lymphocytes after 3 days of rhG-CSF with T lymphocytes increasing 1.5-2.0 times baseline by day 3 or rhG-CSF administration. All lymphocyte phenotypes returned to below pretreatment levels on days 4 and 5 of rhG-CSF administration. The ratio of CD4/CD8 lymphocytes was not affected by rhG-CSF. Collection of PBMCs on 3 consecutive days yielded a mean of 8.77 x 10(8) CD34 cells, 14.03 x 10(10) total nucleated cells and 3.17 x 10(10) CD3 lymphocytes. These data suggest that rhG-CSF mobilized PBMCs have approximately one log more T cells than marrow and the effect of rhG-CSF on the quantity and phenotype of lymphocytes is minimal. Strategies for coping with an increased incidence of GVHD, if it occurs, could include the utilization of both methotrexate and cyclosporine as immunoprophylaxis, selective T cell depletion or CD34 positive selection.
在13名个体(11例自体移植患者和2名正常供者)中,已确定重组人粒细胞集落刺激因子(rhG-CSF)对单采产物中外周血淋巴细胞及淋巴细胞亚群的影响。这些个体在接受rhG-CSF 16微克/千克/天,共5天的治疗过程中,于第3、4和5天采集外周血单个核细胞(PBMC)。rhG-CSF治疗4天和5天后,CD34+细胞的绝对数量分别比治疗前水平增加了9倍和25倍。所有患者在rhG-CSF治疗3天后,CD3、CD4、CD8、CD19和CD20淋巴细胞均增加,T淋巴细胞在rhG-CSF给药第3天时增加至基线水平的1.5 - 2.0倍。在rhG-CSF给药第4天和第5天,所有淋巴细胞表型均恢复至治疗前水平以下。rhG-CSF未影响CD4/CD8淋巴细胞的比例。连续3天采集PBMC,平均获得8.77×10⁸个CD34细胞、14.03×10¹⁰个总核细胞和3.17×10¹⁰个CD3淋巴细胞。这些数据表明,rhG-CSF动员的PBMC中的T细胞比骨髓中的大约多一个对数级,且rhG-CSF对淋巴细胞数量和表型的影响极小。如果发生移植物抗宿主病(GVHD)发生率增加的情况,应对策略可包括使用甲氨蝶呤和环孢素进行免疫预防、选择性T细胞清除或CD34阳性选择。