Urbano-Ispizua A, Solano C, Brunet S, Hernández F, Sanz G, Alegre A, Petit J, Besalduch J, Vivancos P, Díaz M A, Moraleda J M, Carreras E, Ojeda E, de la Rubia J, Benet I, Domingo-Albós A, García-Conde J, Rozman C
Hospital Clinic, Barcelona, Spain.
Bone Marrow Transplant. 1996 Jul;18(1):35-40.
The results of 33 allogeneic peripheral blood progenitor cells transplants (allo-PBPCT) in adult patients with hematologic malignancies were analyzed in a retrospective and multicenter study. In 21 of 33 cases (63%) the disease was refractory or in advanced stage and eight of the 33 cases (24%) were second transplants after relapse. Donors were treated with a median of 10 (4-16) micrograms/kg/day of rhG-CSF subcutaneously for 5-7 days. Three required a central venous line for harvesting. Peripheral blood leukapheresis product contained a median of 5.9 (1.8-13) 10(6)/kg CD34+ cells and a median of 309.5 (153-690) 10(6)/kg CD3+ cells. After a myeloablative regimen, all patients received PBPC from HLA-identical donors as the sole source of progenitor cells. Cyclosporin A (CsA) alone (n = 2), CsA and steroids (n = 9), and CsA and methotrexate (MTX) (n = 22) were used for GVHD prophylaxis. Growth factors post-transplant were given to 11 patients (33%). The median follow-up of the patients was 3 months. Actuarial median day for hemopoietic recovery was: neutrophils to >0.5 (>1) x 10(9)/l, day 14 (15); platelets to >20 (>50) x 10(9)/l, day 14 (21). The quantity of CD34+ cells infused did not significantly affect the engraftment kinetics, from a starting cutoff of 2.5 x 10(6)/kg. The speed of neutrophil recovery seemed to be influenced strongly by using rhG-CSF post-transplant and marginally by the type of GVHD prophylaxis. Actuarial probability for grade II-IV acute GVHD of the whole group was 37% (95% Cl, 20-54%).
一项回顾性多中心研究分析了33例血液系统恶性肿瘤成年患者接受异基因外周血祖细胞移植（allo-PBPCT）的结果。33例患者中，21例（63%）疾病为难治性或晚期，33例中的8例（24%）为复发后二次移植。供者皮下注射重组人粒细胞集落刺激因子（rhG-CSF）的剂量中位数为10（4 - 16）微克/千克/天，共5 - 7天。3例采集时需要中心静脉置管。外周血白细胞分离产物中CD34+细胞的中位数为5.9（1.8 - 13）×10⁶/千克，CD3+细胞的中位数为309.5（153 - 690）×10⁶/千克。在进行清髓性预处理后，所有患者均接受来自 HLA 配型相合供者的外周血祖细胞作为祖细胞的唯一来源。预防移植物抗宿主病（GVHD）分别采用单独使用环孢素A（CsA）（n = 2）、CsA加类固醇（n = 9）以及CsA加甲氨蝶呤（MTX）（n = 22）。11例患者（33%）移植后给予生长因子。患者的中位随访时间为3个月。造血恢复的精算中位天数为：中性粒细胞计数>0.5（>1）×10⁹/升，第14天（第15天）；血小板计数>20（>50）×10⁹/升，第14天（第21天）。从起始临界值2.5×10⁶/千克起，输注的CD34+细胞数量对植入动力学无显著影响。中性粒细胞恢复速度似乎受移植后使用rhG-CSF的强烈影响，受GVHD预防类型的影响较小。全组II - IV级急性GVHD的精算概率为37%（95%可信区间，20 - 54%）。
