Johnson R J, Owen R G, Smith G M, Child J A, Galvin M, Newton L J, Rawstron A, Major K, Woodhead V, Robinson F, Jack A, Morgan G J
Department of Haematology, General Infirmary at Leeds, UK.
Bone Marrow Transplant. 1996 May;17(5):723-7.
We have performed nine CD34 selection procedures on peripheral blood stem cells harvested from eight patients with myeloma using the Cellpro avidin-biotin immunoaffinity column (Ceprate). They all received CVAMP chemotherapy to maximum response prior to mobilisation. Six of the patients have been transplanted using these cells, one receiving successive autografts. Median absolute cell numbers processed and retrieved were: 31.1 x 10(9) pre-column, 2.07 x 10(8) in the final product and 30.4 x 10(9) in the column waste. Mean CD34 positivity in the product was 49% (range 18.4-98) with a median CD34+ yield of 31.4% (range 21-37.8). IgH PCR was performed and seven of the eight patients were amplifiable. Of these, two were positive in the pre-column product and both of these were successfully purged with a negative result in the final, post-column product. Patients were transplanted with a median of 2.0 x 10(6) CD34+ cells/kg (range 1.5-9.4) following conditioning with melphalan 200 mg/m2. The mean time to recovery of neutrophils to > 0.5 x 10(9)/l and platelets to > 20 x 10(9)/l was 16 and 17 days, respectively. At a mean follow-up of 9 months, four of the six patients transplanted are alive, three of them in complete remission and one in a clinically stable relapse. One has died of disease relapse and one of progressive neurological problems the aetiology of which was uncertain but there was no sign of progression of their myeloma. We conclude that PBSCT using CD34 selected cells is safe and practical in myeloma following remission induction with CVAMP chemotherapy.
我们使用Cellpro抗生物素蛋白-生物素免疫亲和柱（Ceprate）对8例骨髓瘤患者采集的外周血干细胞进行了9次CD34选择程序。他们在动员前均接受了CVAMP化疗直至达到最大反应。其中6例患者已使用这些细胞进行了移植，1例接受了连续自体移植。处理和回收的中位绝对细胞数分别为：柱前31.1×10⁹，最终产物中2.07×10⁸，柱废物中30.4×10⁹。产物中CD34的平均阳性率为49%（范围18.4 - 98），CD34⁺产量中位数为31.4%（范围21 - 37.8）。进行了IgH PCR检测，8例患者中有7例可扩增。其中，2例在柱前产物中呈阳性，这2例均成功清除，最终柱后产物结果为阴性。患者在接受200mg/m²美法仑预处理后，以中位数2.0×10⁶个CD34⁺细胞/kg（范围1.5 - 9.4）进行移植。中性粒细胞恢复至>0.5×10⁹/L和血小板恢复至>20×10⁹/L的平均时间分别为16天和17天。平均随访9个月时，6例移植患者中有4例存活，其中3例完全缓解，1例临床稳定复发。1例死于疾病复发，1例死于病因不明的进行性神经问题，但无骨髓瘤进展迹象。我们得出结论，在CVAMP化疗诱导缓解后，使用CD34选择细胞进行自体造血干细胞移植在骨髓瘤治疗中是安全可行的。
