Di Nicola M, Siena S, Bregni M, Belli N, Milanesi M, Ruffini P A, Malaffo F, Ravagnani F, Gianni A M
Cristina Gandini Transplantation Unit, Instituto Nazionale Tumori, Milan, Italy.
Bone Marrow Transplant. 1996 Sep;18(3):619-23.
In two groups of 11 patients with poor prognosis malignancies undergoing high-dose sequential chemotherapy, we have evaluated the cryopreservation of blood cell transplants with oxypolygelatine-containing (55% oxypolygelatine, 6% hydroxyethylstarch, 5% dimethyl sulfoxide) vs standard human serum-containing (55% human serum, 6% hydroxyethylstarch, 5% dimethyl sulfoxide) cryoprotectant mixtures. Evidence is presented demonstrating that substitution of human serum proteins with oxypolygelatine has no detrimental effect either in vitro on the post-thawing recovery of hematopoietic progenitors or in vivo on the capacity of marrow reconstituting function in patients treated with myeloablative cancer therapy and autologous blood cell transplant. Oxypolygelatine is commercially available for clinical use as a plasma expander, is 30-fold less expensive than human serum albumin, is certified free of foreign serum proteins and antibodies as well as free of pyrogen, viral, mycoplasmal and bovine spongiform encephalopathy contaminants. Because of these characteristics, oxypolygelatine permits avoidance of: (1) the use of expensive serum albumin; (2) the fastidious preparation of autologous plasma or serum, and (3) the risk of infection associated with the infusion of allogeneic serum. Because of these practical advantages, we recommend the clinical use of oxypolygelatine as a substitute for human serum proteins for the routine cryopreservation of blood cell transplants.
在两组共11例预后不良的恶性肿瘤患者接受大剂量序贯化疗时，我们评估了含氧化聚明胶（55%氧化聚明胶、6%羟乙基淀粉、5%二甲基亚砜）与含标准人血清（55%人血清、6%羟乙基淀粉、5%二甲基亚砜）的冷冻保护剂混合物对血细胞移植的冷冻保存效果。有证据表明，用氧化聚明胶替代人血清蛋白，在体外对造血祖细胞解冻后的恢复以及在体内对接受清髓性癌症治疗和自体血细胞移植患者的骨髓重建功能能力均无不利影响。氧化聚明胶作为血浆扩容剂可在临床上商购获得，其价格比人血清白蛋白便宜30倍，经认证不含外源血清蛋白和抗体，也不含热原、病毒、支原体和牛海绵状脑病污染物。由于这些特性，氧化聚明胶可避免：（1）使用昂贵的血清白蛋白；（2）繁琐地制备自体血浆或血清；以及（3）与输注异体血清相关的感染风险。鉴于这些实际优势，我们建议临床上使用氧化聚明胶替代人血清蛋白用于血细胞移植的常规冷冻保存。
