Rozman C, Urbano-Ispizua A, Carreras E, Sierra J, Marin P, Rovira M, Merino A, Batlle M, Briones J, Mazzara R, Montserrat E
Postgraduate School of Haematology "Farreras Valenti", Hospital Clinic, University of Barcelona, Spain.
Leuk Lymphoma. 1996 Feb;20(5-6):471-4. doi: 10.3109/10428199609052431.
Six patients with high-risk leukaemia received a myeloablative regimen followed by allogeneic peripheral blood progenitor cells transplantation (PBPCT) from an HLA-identical sibling donor. Donors received 10-12 mu g/kg/day of G-CSF subcutaneously for 5 days. G-CSF was well tolerated except for moderate bone pain. Peripheral blood leukapheresis product contained 1-4 times more CD34+ cells and approximately a log more of T lymphocytes than marrow grafts from normal donors. In the two first cases the leukapheresis product was partially depleted of T-lymphocytes using counterflow centrifugation. No growth-factors were administered post-transplant. GVHD prophylaxis consisted of cyclosporin A (CyA) in one case, and CyA and methotrexate in five cases. All patients engrafted with a neutrophil count reaching more than 0.5 x 10(9)/L by day 12 to 21 post-transplant and a platelet count above 20 x 10(9)/L by day 6 to 41 post-transplant. Acute GVHD was clinical grade 0 (n = 2), I (n = 1), II (n = I), grade III (n = I) and grade IV (n = 1). One case presents an extensive chronic cutaneous GVHD and is currently being treated with methylprednisolone. In conclusion, allogeneic transplants using PBPC can be performed safely. This may result in a rapid neutrophil and platelet engraftment, without an apparent increased risk of GVHD.
6例高危白血病患者接受了清髓方案，随后接受来自 HLA 相同同胞供体的异基因外周血祖细胞移植（PBPCT）。供体皮下注射 10 - 12μg/kg/天的 G-CSF，共 5 天。除中度骨痛外，G-CSF 的耐受性良好。外周血白细胞分离产物中的 CD34+细胞比正常供体的骨髓移植物多 1 - 4 倍，T 淋巴细胞大约多一个对数级。在前两例中，使用逆流离心法对外周血白细胞分离产物进行了部分 T 淋巴细胞清除。移植后未给予生长因子。移植物抗宿主病（GVHD）预防措施在 1 例中采用环孢素 A（CyA），在 5 例中采用 CyA 和甲氨蝶呤。所有患者均在移植后第 12 至 21 天中性粒细胞计数达到超过 0.5×10⁹/L，在移植后第 6 至 41 天血小板计数超过 20×10⁹/L 时实现造血重建。急性 GVHD 的临床分级为 0 级（n = 2）、I 级（n = 1）、II 级（n = 1）、III 级（n = 1）和 IV 级（n = 1）。1 例出现广泛的慢性皮肤 GVHD，目前正在接受甲泼尼龙治疗。总之，使用外周血祖细胞进行异基因移植可以安全进行。这可能导致中性粒细胞和血小板快速植入，而不会明显增加 GVHD 的风险。
