Mitchell P L, Shepherd V B, Proctor H M, Dainton M, Cabral S D, Pinkerton C R
Royal Marsden Hospital, Paediatric Unit.
Arch Dis Child. 1994 Mar;70(3):237-40. doi: 10.1136/adc.70.3.237.
Peripheral blood stem cells (PBSC) were used to augment autologous bone marrow transplantation (ABMT), aiming to hasten engraftment after high dose treatment in a group of heavily pretreated patients. PBSC were obtained by leukapheresis during the rebound after standard chemotherapy. In 11 patients aged 7-17 years, high dose chemotherapy consisted of busulphan 16 mg/kg orally with melphalan 160 mg/m2 intravenously for seven patients, and melphalan 200 mg/m2 intravenously alone for four. The median number of granulocyte-macrophage colony forming units in the reinfused PBSC was 3.42 x 10(4)/kg (3.03-18.01) and bone marrow 12.4 x 10(4)/kg (4.16-28.6). Neutrophil recovery to > or = 0.5 x 10(9)/l and platelet transfusion independence occurred at a median of 14 days (11-18) and 22 days (9-84) respectively. In five patients the early engraftment was transient with neutrophils again dropping below 0.5 x 10(9)/l then slowly recovering. There was one toxic death due to sepsis. PBSC harvesting in these children was undertaken without interrupting routine chemotherapy and without the use of bone marrow growth factors. In some patients PBSC failed to influence engraftment and the use of combined chemotherapy and growth factor priming for PBSC collection may give improved results.
外周血干细胞（PBSC）被用于加强自体骨髓移植（ABMT），目的是在一组经过大量预处理的患者接受高剂量治疗后加速植入。PBSC是在标准化疗后的回升期通过白细胞分离术获得的。11名年龄在7至17岁的患者中，7名患者的高剂量化疗包括口服白消安16mg/kg和静脉注射美法仑160mg/m²，另外4名患者仅静脉注射美法仑200mg/m²。回输的PBSC中粒细胞 - 巨噬细胞集落形成单位的中位数为3.42×10⁴/kg（3.03 - 18.01），骨髓为12.4×10⁴/kg（4.16 - 28.6）。中性粒细胞恢复至≥0.5×10⁹/L和血小板不再需要输注的中位时间分别为14天（11 - 18天）和22天（9 - 84天）。5名患者的早期植入是短暂的，中性粒细胞再次降至0.5×10⁹/L以下，然后缓慢恢复。有1例因败血症导致的毒性死亡。这些儿童的PBSC采集在不中断常规化疗且不使用骨髓生长因子的情况下进行。在一些患者中，PBSC未能影响植入，联合化疗和生长因子预处理用于PBSC采集可能会取得更好的效果。
