单个核细胞绝对计数对恶性血液病患者自体外周血干细胞采集结果及时机选择的意义

目的探讨一种快速、简捷判断恶性血液病自体外周血干细胞最佳采集时机的方法。方法 37例次行自体外周血干细胞移植（auto-PBSCT）的不同类型恶性血液病患者,以化疗＋粒细胞集落刺激因子（rhG-CSF）动员,采集前进行外周血白细胞（WBC）、单个核细胞（MNC）比例测定及其绝对计数,以血细胞分离机进行外周血干细胞采集,应用流式细胞术（FCM）监测CD34＋细胞计数。结果采集产品的MNC中位数为1.76×108/kg,CD34＋细胞中位数为1.35×106/kg;MNC绝对计数是产品MNC和CD34＋细胞总量的唯一相关指标,而外周血WBC计数和MNC比例与采集产品MNC和CD34＋细胞总量无关。进一步分析提示MNC绝对计数达10×108/L单次采集效率提高,中位CD34＋细胞采集量达1×106/kg以上,可作为启动采集的阈值。结论外周血MNC的绝对计数能快速、简便地动态监测外周造血干细胞的变化,为外周血造血干细胞最佳采集时机的判断提供了一种快捷、经济的参考方法。

Significance of mononuclear cell count on the harvest of mobilized autologous peripheral hematopoietic stem cells transplantation with hematological malignancies

Objective To develop a simple method to rapidly determine the optimal time of peripheral blood stem cell harvest for autologous peripheral blood stem cell transplantation（auto-PBSCT） with hematological malignancies.Methods A total of 37 apherosis for auto-PBSCT were analysed.The white blood cell（WBC） count mononuclear cell（MNC） proportion and count were detected before harvest and CD34＋ cells count of products were analyzed by（FCM）.Results The median number of MNC in products was 1.76×108/kg with median CD34＋ cells was 1.35×106/kg.The MNC count was the only parameter associated with the MNC and CD34＋ cell numbers in the harvest products.When the peripheral MNC count reach 10×108/L,the efficacy of a single apheresis significantly improved with CD34＋ cells,which indicated that when the peripheral MNC count reach 10×108/L,the harvest stared.Conclusion Peripheral MNC count can rapidly monitor the variety of hematopoietic stem cells in auto-PBSCT with hematological malignancies,and can provide a simple and economic method to determine the optimal time of peripheral blood stem cell harvest.