Abonour R, Scott K M, Kunkel L A, Robertson M J, Hromas R, Graves V, Lazaridis E N, Cripe L, Gharpure V, Traycoff C M, Mills B, Srour E F, Cornetta K
Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.
Bone Marrow Transplant. 1998 Nov;22(10):957-63. doi: 10.1038/sj.bmt.1701473.
In the use of autologous PBPC transplantation in patients with multiple myeloma, contamination of PBPC with myeloma cells is commonly observed. Enrichment for CD34+ cells has been employed as a method of reducing this contamination. In this study the reduction of myeloma cells in PBPC was accomplished by the positive selection of CD34+ cells using immunomagnetic bead separation (Isolex 300 system). PBPC were mobilized from 18 patients using cyclophosphamide (4.5 g/m2) and G-CSF (10 microg/kg/day). A median of two leukaphereses and one selection was performed per patient. The median number of mononuclear cells processed was 3.50 x 10(10) with a recovery of 1.11 x 10(8) cells after selection. The median recovery of CD34+ cells was 48% (range 17-78) and purity was 90% (29-99). The median log depletion of CD19+ cells was 3.0. IgH rearrangement, assessed by PCR, was undetectable in 13 of 24 evaluable CD34+ enriched products. Patients received 200 mg/m2 of melphalan followed by the infusion of a median of 2.91 x 10(6)/kg CD34+ cells (1.00-16.30). The median time to absolute neutrophil count >0.5 x 10(9)/l was 11 days, and sustained platelet recovery of >20 x 10(9)/l was 14 days. We conclude that immunomagnetic-based enrichment of CD34+ cells results in a marked reduction in myeloma cells without affecting engraftment kinetics.
在多发性骨髓瘤患者中使用自体外周血造血干细胞（PBPC）移植时，通常会观察到PBPC被骨髓瘤细胞污染。富集CD34+细胞已被用作减少这种污染的一种方法。在本研究中，通过使用免疫磁珠分离法（Isolex 300系统）对CD34+细胞进行阳性选择，实现了PBPC中骨髓瘤细胞的减少。使用环磷酰胺（4.5 g/m2）和粒细胞集落刺激因子（G-CSF，10 μg/kg/天）从18例患者中动员PBPC。每位患者平均进行两次白细胞单采和一次选择。处理的单个核细胞中位数为3.50×10¹⁰，选择后回收1.11×10⁸个细胞。CD34+细胞的中位回收率为48%（范围17 - 78），纯度为90%（29 - 99）。CD19+细胞的中位对数减少率为3.0。通过聚合酶链反应（PCR）评估，在24个可评估的CD34+富集产物中有13个未检测到免疫球蛋白重链（IgH）重排。患者接受200 mg/m2的美法仑，随后输注中位数为2.91×10⁶/kg的CD34+细胞（1.00 - 16.30）。绝对中性粒细胞计数>0.5×10⁹/L的中位时间为11天，血小板持续恢复至>20×10⁹/L的时间为14天。我们得出结论，基于免疫磁珠的CD34+细胞富集可显著减少骨髓瘤细胞，且不影响植入动力学。
