巨细胞病毒对人骨髓粒-巨噬系祖细胞生长的影响

目的探讨人巨细胞病毒（ＨＣＭＶ）对人骨髓粒巨噬系祖细胞集落（ＣＦＵＧＭ）是否有直接抑制作用。方法采用造血祖细胞体外培养技术,研究病毒株ＨＣＭＶＡＤ１６９对ＣＦＵＧＭ生长的影响,用原位聚合酶链反应（ＩＳＰＣＲ）技术检测ＣＦＵＧＭ的细胞内ＨＣＭＶＡＤ１６９ＤＮＡ。结果高浓度ＨＣＭＶＡＤ１６９（２×１０６ｐｆｕ／ｍｌ和２×１０５ｐｆｕ／ｍｌ）在体外能明显抑制ＣＦＵＧＭ的生长（Ｐ＜０．０１）,而低浓度（２×１０４ｐｆｕ／ｍｌ）ＨＣＭＶＡＤ１６９则无此作用,ＨＣＭＶＡＤ１６９对骨髓ＣＦＵＧＭ的抑制作用因其浓度的不同而有差异;经ＩＳＰＣＲ检测发现在ＣＦＵＧＭ的细胞核中存在ＨＣＭＶＡＤ１６９ＤＮＡ。结论ＣＦＵＧＭ是ＨＣＭＶＡＤ１６９的宿主细胞之一,ＨＣＭＶＡＤ１６９对骨髓ＣＦＵＧＭ生长的抑制作用与其对ＣＦＵＧＭ的直接感染有关。     

获得性单纯无巨核细胞性血小板减少性紫癜发病机制的研究

目的研究获得性单纯无巨核细胞性血小板减少性紫癜（ＡＰＡＴＰ）的发病机制。方法患者骨髓单个核细胞（ＭＮＣ）以甲基纤维素培养法测定其ＣＦＵＧＭ,ＣＦＵＥ和ＣＦＵＭＫ。观察去除骨髓中Ｔ细胞和粘附细胞对ＣＦＵＭＫ的影响。患者血清或ＩｇＧ在培养前与正常或自身ＭＮＣ孵育,检测对ＣＦＵＭＫ的体液抑制作用。结果１５例（５３．６％）的发病由于ＣＦＵＭＫ的内在缺陷。３例去Ｔ细胞,２例去单核巨噬细胞后,骨髓巨核细胞集落形成明显增加。６例（２１．４％）血清抑制ＣＦＵＭＫ,此种抑制物来自ＩｇＧ,选择性地针对巨核细胞。２例发病机制未定。结论巨核祖细胞的内在缺陷是ＡＰＡＴＰ的主要发病机制。部分患者可因异常免疫引起。ＭＫＣＳＡ生成的失代偿可能也是一个重要病因。     

低分子量硫酸葡聚糖对Beagle狗外周血造血细胞动员作用的研究

为研究可供人体应用的造血干细胞动员剂，将低分子量硫酸葡聚糖（ＤＳ）给Ｂｅａｇｌｅ狗静脉注射，观察其对造血干细胞的动员作用。结果显示，注射ＤＳ１５ｍｇ／ｋｇ后１小时，外周血中ＷＢＣ、单个核细胞（ＭＮＣ）和ＣＦＵ－ＧＭ计数开始升高，３小时达到峰值，每升血中的数量分别为给药前的１．６，２．１和４．５倍。外周血中ＷＢＣ、ＭＮＣ计数随ＤＳ剂量增加而增加，注射ＤＳ６０ｍｇ／ｋｇ时ＷＢＣ、ＭＮＣ数分别为给药前的２．１和４．０倍。以１５ｍｇ／ｋｇ或３０ｍｇ／ｋｇ组狗外周血中各系祖细胞升高幅度最大，每升血中ＣＦＵ－ＧＭ、ＣＦＵ－Ｍｅｇ、ＢＦＵ－Ｅ和ＣＦＵ－Ｍｉｘ计数分别为给药前的９．０，６．８，１０．３和１３．０倍。     

阵发性睡眠性血红蛋白尿症患者T淋巴细胞对造血祖细胞的影响

目的：研究阵发性睡眠性血红蛋白尿症（ＰＮＨ）患者的Ｔ淋巴细胞对造血祖细胞的影响。方法：将ＰＮＨ患者外周血制备的植物血凝素刺激的Ｔ淋巴细胞条件培养液（ＰＨＡＴＣＭ）加入造血祖细胞的培养基中，用于ＰＮＨ患者和正常人骨髓的粒巨噬细胞系集落形成单位（ＣＦＵＧＭ）和红系爆式集落形成单位（ＢＦＵＥ）的培养。结果：在含有初发ＰＮＨ患者的ＰＨＡＴＣＭ培养条件下，ＰＮＨ患者和正常人骨髓ＣＦＵＧＭ和ＢＦＵＥ数明显低于含有正常人ＰＨＡＴＣＭ培养条件下的集落数；在含有好转和治愈的ＰＮＨ患者的ＰＨＡＴＣＭ培养条件下，正常人骨髓ＣＦＵＧＭ和ＢＦＵＥ数增加和恢复到正常范围。结论：初发ＰＮＨ患者的Ｔ淋巴细胞对造血祖细胞的支持作用减弱，治愈的ＰＮＨ患者的Ｔ淋巴细胞对造血祖细胞的支持作用恢复正常     

小鼠c-kit~＋Sca-1~＋和c-kit~＋Sca-1~－细胞代表不同分化阶段的造血干／祖细胞

为深入研究造血干细胞（ＨＳＣ）的生物学功能，根据表面标志，采用流式细胞仪分离和富集了小鼠骨髓中两类不同特征的ＨＳＣ亚群ｃ－ｋｉｔ＋Ｓｃａ－１＋和ｃ－ｋｉｔ＋Ｓｃａ－１－细胞。体外集落培养表明ｃ－ｋｉｔ＋Ｓｃａ－１＋细胞对ＩＬ－３或ＧＭ－ＣＳＦ单独刺激无反应，而ｃ－ｋｉｔ＋Ｓｃａ－１－细胞则可形成大小不等的细胞集落。多种造血生长因子［ＩＬ－３＋ＩＬ－６＋ＧＭ－ＣＳＦ＋Ｇ－ＣＳＦ＋Ｅｐｏ＋干细胞生长因子（ＳＣＦ）］联合可诱导ｃ－ｋｉｔ＋Ｓｃａ－１＋细胞形成大的细胞集落，但在培养１２天时尚无ＢＦＵ－Ｅ和粒、单核、红和巨核系细胞集落（ＣＦＵ－ＧＥＭＭ）形成；而同样条件下，ｃ－ｋｉｔ＋Ｓｃａ－１－细胞可形成ＢＦＵ－Ｅ和ＣＦＵ－ＧＥＭＭ以及其它各类集落。体内实验表明ｃ－ｋｉｔ＋Ｓｃａ－１＋细胞在培养８天时无脾集落（ＣＦＵ－Ｓ）形成，与ｃ－ｋｉｔ＋Ｓｃａ－１－细胞显著不同（Ｐ＜０．０１）。相反，ｃ－ｋｉｔ＋Ｓｃａ－１＋细胞包含了骨髓造血重建活性细胞，而ｃ－ｋｉｔ＋Ｓｃａ－１－细胞则缺乏。结果提示ｃ－ｋｉｔ＋Ｓｃａ－１＋细胞为早期的具重建长期造血功能的干细胞，而ｃ－ｋｉｔ＋Ｓｃａ－１－细胞则为相对分化后期的造血祖细胞。     

人脐血造血干,祖细胞体外培养的实验研究

采用体外细胞培养的方法，检测了脐血、骨髓、外周血ＣＦＵ－ＧＭ，ＢＦＵ－Ｅ。结果表明脐血中ＣＦＵ－ＧＭ，ＢＦＵ－Ｅ数量高于成人外周血，同骨髓相比，ＣＦＵ－ＧＭ数量无显著差异，ＢＦＵ－Ｅ低于骨髓。同时观察到脐血中ＣＦＵ－ＧＭ大集落比例明显高于骨髓；ＣＦＵ－ＧＭ集落产率时间曲线较骨髓延迟３～４天；Ｓ期ＧＭ－ＣＦＣ所占比例明显低于骨髓，可能提示脐血造血细胞中早期造血细胞比例高于骨髓。实验中还发现脐血红系集落生长同骨髓十分相似，二者均含ＣＦＵ－Ｅ和ＢＦＵＥ集落，而外周血中只含ＢＦＵ－Ｅ集落。我们统计了２７份脐血血量及所含有核细胞数。根据骨髓移植的有核细胞数标准（２×１０￣８／ｋｇ），一份脐血的有核细胞数很难达到此要求，但已达到目前国外小儿异体脐血移植成功病例的有核细胞数值。     

G－CSF对化疗后外周血干细胞动员作用的影响

通过对１１例急性白血病患者单独化疗与化疗后加用粒细胞集落刺激因子（Ｇ－ＣＳＦ）的对比，动态观察了Ｇ－ＣＳＦ对外周血造血干细胞（ＰＢＳＣ）的动员作用。发现化疗后加用Ｇ－ＣＳＦ比单用化疗的粒－巨噬细胞集落形成单位（ＣＦＵ－ＧＭ）增加５．１倍，红系爆式集落形成单位（ＢＦＵ－Ｅ）增加４．５倍。Ｇ－ＣＳＦ还可使ＣＦＵ－ＧＭ＞１００／ｍｌ和ＢＦＵ－Ｅ＞２００／ｍｌ的持续时间延长；化疗后ＣＦＵ－ＧＭ的最高值提早出现，而不影响ＢＦＵ－Ｅ／ＣＦＵ－ＧＭ比值。结果表明，化疗后加用Ｇ－ＣＳＦ可明显提高ＰＢＳＣ的收集效率，Ｇ－ＣＳＦ是一种有效的ＰＢＳＣ动员剂。     

caspase 3在细胞因子调节急性白血病细胞凋亡中的变化

目的 研究ｃａｓｐａｓｅ３在粒细胞集落刺激因子（Ｃ－ＣＳＦ）和粒巨洚细胞集落因子（ＧＭ－ＣＳＦ）调节白血病细胞系ＮＢ４细胞凋亡过程中的变化及其意义。方法 利用细胞这、流式细胞仪分析及ＤＮＡ片段化比率测定,检测Ｇ－ＣＳＦ及ＤＭ－ＣＳＦ对ＮＢ４细胞凋亡的影响,应用荧光分光光度法检测ｃａｓｐａｓｅ３活性变化,并利用ＡＥ－ＤＥＶＤ－ＣＲＯ进行ｃａｓｐａｓｅ３抑制试验。结果 Ｇ－ＣＳＦ能诱导ＮＢ４细胞凋亡,     

脐血造血祖细胞培养及T淋巴细胞亚群的研究

采用甲基纤维素半固体体外培养法对脐带血造血祖细胞进行研究。人脐带血粒单祖细胞集落（ＣＦＵ－ＧＭ），红系爆式集落（ＢＦＵ－Ｅ）含量显著高于成人外周血，也高于骨髓（ＣＦＵ－ＧＭ，Ｐ＜０．０５；ＢＦＵ－Ｅ，Ｐ＜０．０１）。脐血造血祖细胞的出现晚于骨髓，但存活时间较长。在不外加促红细胞生成素时，脐血中有少量ＢＦＵ－Ｅ生成。将两份不同胎儿的脐血细胞混合后培养并与单个胎儿脐血细胞培养相比较，两者在祖细胞生成数量和生长特征方面无明显差别。采用单克隆抗体技术检测脐血中ＯＫＴ＿３，ＯＫＴ＿４，ＯＫＴ＿８阳性率，与成人相比，ＯＫＴ＿３￣＋降低，而ＯＫＴ＿４￣＋，ＯＫＴ＿８￣＋和ＯＫＴ＿４￣＋／ＯＫＴ＿８￣＋与成人相似。     

不同造血生长因子对脐血有核细胞体外扩增作用的实验研究

目的：探讨造血生长因子不同组合方式对脐血有核细胞的扩增作用以及脐血扩增后Ｔ淋巴细胞和ＨＬＡ－ＡＢ、ＤＲ阳性细胞变化情况。方法：在脐血有核细胞体外培养体系中分别加入不同组合的细胞因子，观察细胞数、ＣＤ３４＋细胞、ＣＦＵ－ＧＭ、Ｔ４（ＣＤ４＋ＣＤ８－ＣＤ３＋）细胞、Ｔ８（ＣＤ４－ＣＤ８＋ＣＤ３＋）细胞以及ＨＬＡ－ＡＢ、ＤＲ阳性细胞的变化。结果：脐血有核细胞在体外液体培养体系中，经重组人干细胞因子（ｒｈＳＣＦ）、白细胞介素（ＩＬ）－３、ＩＬ－６、粒细胞集落刺激因子（Ｇ－ＣＳＦ）、粒－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）和红细胞生成素（Ｅｐｏ）的作用下扩增效果最佳。结论：脐血有核细胞在各种造血生长因子的协同作用下可以在体外扩增。脐血扩增后Ｔ４、Ｔ８细胞减少，可能会降低脐血移植急性ＧＶＨＤ发生，但ＨＬＡ－ＡＢ和ＨＬＡ－ＤＲ阳性细胞数急剧上升，增加了免疫排斥的可能性。     

Effects of the angiotensin-converting enzyme inhibitor enalapril on blood haematopoietic progenitors and Acetyl-N-Ser-Asp-Lys-Pro concentrations

Acetyl-N-Ser-Asp-Lys-Pro (AcSDKP) is a physiological inhibitor of the proliferation of haematopoietic stem cells. In 12 healthy volunteers treated with the angiotensin-converting enzyme (ACE) inhibitor enalapril (20 mg day⁻¹ for 15 days), we studied plasma and urinary AcSDKP levels, the in vitro degradation of AcSDKP by plasma ACE and the numbers of circulating haematopoietic progenitors (granulocyte-monocytic colony forming unit: CFU-GM; burst forming unit-erythroid: BFU-E; and mixed colony forming unit: CFU-mixed). During treatment, plasma and urinary AcSDKP concentrations increased 2- to 5-fold, degradation of AcSDKP was reduced, and CFU-mixed significantly increased by 100% while BFU-E and CFU-GM significantly decreased by 16% and 26%, respectively. These results indicate that ACE inhibitors may be of value during chemotherapy or radiotherapy, warranting further study.     

Suppressive effects of TNF-alpha, TGF-beta1, and chemokines on megakaryocytic colony formation in CD34+ cells derived from umbilical cord blood compared with mobilized peripheral blood and bone marrow

CD34+ cells from human umbilical cord blood (CB) were isolated and investigated for megakaryocytic (MK) colony formation in response to recombinant human (rh) stimulatory and suppressive cytokines and compared with their counterparts in normal BM and G-CSF-mobilized peripheral blood (mPBL). First, we observed that IL-11 by itself at any dosage had no stimulator activity on MK colony formation derived from CD34+ cells in CB, mPBL, and BM. IL-3, steel factor (SLF), or thrombopoietin (Tpo) alone stimulated numbers of colony-forming unit-megakaryocyte (CFU-MK) in a dose-dependent fashion. Maximum growth of MK progenitor cells was noted in the presence of a combination of cytokines: IL-11, IL-3, SLF, and Tpo. The frequency of CFU-MK in CB and mPBL was significantly greater than that in BM, and the size of colonies in CB and mPBL was significantly greater than that in BM, and the size of colonies was larger as well. In addition, an increased number of big mixed colonies containing MK were observed in CB and mPBL. In the presence of IL-11, IL-3, SLF, and Tpo, CFU-MK derived from CB, mPBL, and BM was suppressed by tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta1 (TGF-beta1). CFU-MK derived from normal BM was inhibited by some chemokines evaluated, whereas CFU-MK derived from CB was suppressed only by platelet factor-4 (PF-4), IFN-inducible protein-10 (IP-10), Exodus-1, Exodus-2, and Exodus-3, but to a lesser degree. In CB, unlike granulocyte-macrophage (CFU-GM), erythroid (BFU-E), high-proliferative potential (HPP-CFC), or multipotential (CFU-GEMM) progenitors, at least a subpopulation of MK progenitors are in S-phase. Therefore, CB MK progenitors respond to the suppressive effects of some members of the chemokine family. Similar results were noted for burst-forming unit-MK (BFU-MK). Our results indicate that CB and mPBL are rich sources of MK progenitors and that MK progenitors in CB are responsive to the suppressive effects of TNF-alpha and TGF-beta1 and some members of the chemokine family.     

Activity of acetyl-Ser-Asp-Lys-Pro (AcSDKP) on human hematopoietic progenitor cells in short-term and long-term bone marrow cultures

The tetrapeptide acetyl-Ser-Asp-Lys-Pro (AcSDKP) is a potent inhibitor of hematopoietic stem cell proliferation. We examined the effects of AcSDKP on the production of granulocyte-macrophage colony-forming cells (CFU-GM) and high proliferative potential colony-forming cells (HPP-CFC) in human long-term bone marrow (LTBM) cultures and CFU-GM and erythroid burst-forming cells (BFU-e) in short-term liquid cultures. The addition of AcSDKP in short-term bone marrow cultures resulted in a maximum depression of the total number of progenitor cells as well as the number of progenitor cells entering cell cycle following culture with 10(-12) to 10(-14) M AcSDKP and 10(-14) M AcSDKP when exogenous cytokines (GM-CSF, IL-3, or SCF) were added. AcSDKP was added daily to LTBM cultures at various concentrations (10(-8) M to 10(-16) M) for up to 5 weeks. In these LTBM culture studies, AcSDKP inhibited the entry of nonadherent progenitor cells into S phase and decreased the number of nonadherent progenitor cells with peak activity at 10(-12) M. In contrast, AcSDKP had no effect on the number of adherent CFU-GM, HPP-CFC, or cellularity per culture or percent of adherent progenitor cells in S phase. These studies indicate that the concentration of the tetrapeptide is critical to the activity of AcSDKP on human hematopoietic progenitor cells. Furthermore, we report that the presence of cytokines or stromal cells also affects the response of progenitor cells to AcSDKP. These results will aid in determining kinetic properties of AcSDKP for the development of clinical protocols to protect normal human hematopoietic stem and progenitor cells following cycle-specific chemotherapy agents.     

骨髓内皮细胞产生造血抑制因子

本研究探讨骨髓内皮细胞分泌的造血抑制因子在扩增造血祖细胞中的作用并初步探讨其作用机制。收集无血清骨髓内皮细胞条件培养液 (BMEC CM) ,离心超滤 ,获得 >1 0kD和 <1 0kD的组分 ,以观察BMEC CM原液及其 >1 0kD和 <1 0kD组分对CFU GM及HPP CFC的增殖作用的影响 ;检测骨髓内皮细胞及BMEC CM中抑制因子的表达 ,用抗体中和实验检测BMEC CM中的抑制因子对造血集落的抑制活性 ;用膜杂交法检测抑制因子联合造血刺激因子扩增造血细胞时增殖与分化相关基因的改变。结果表明 :①BMEC CM ,>1 0kD及 <1 0kD组分分别加入集落培养体系 ,BMEC CM对CFU GM及HPP CFC的生成无明显影响 ,>1 0kD组分增加CFU GM及HPP CFC的生成 ,<1 0kD组分抑制CFU GM及HPP CFC的生成。②BMEC CM ,>1 0kD及 <1 0kD组分分别加入骨髓细胞液体培养体系培养 2 4小时后 ,BMEC CM组CFU GM明显减少 ,HPP CFC显著增加 ;>1 0kD组分组CFU GM明显增加 ,HPP CFC无显著改变 ;<1 0kD组分组CFU GM及HPP CFC均明显减少。③小鼠骨髓内皮细胞表达MIP 2 ,MIP 1α ,MSP ,TGF β,TNF α,IFN γ及Tβ4。BMEC CM中存在有MIP 2 ,MIP 1α ,MSP ,TGF β ,TNF α和Tβ4。④抗体中和实验结果表明在BMEC CM中的TGF β ,MSP ,MIP 1α,IFN γ和Tβ4有明显抑制活性。⑤Tβ4     

Trehalose ameliorates the cryopreservation of cord blood in a preclinical system and increases the recovery of CFUs,long-term culture-initiating cells,and nonobese diabetic-SCID repopulating cells

BACKGROUND: The cryopreservation of HPCs in DMSO has been practiced by cord blood (CB) banks worldwide. Inevitably, some detriment to biologic function occurs as the result of freezing injuries and DMSO toxicity. Trehalose, a disaccharide, is a natural cryoprotectant in organisms capable of surviving extreme dehydration and cold. The objective of this study was to establish the cryopreservation of CB under preclinical conditions using trehalose as a supplement to DMSO. STUDY DESIGN AND METHODS: In a preclinical protocol, the effects of 5-percent trehalose with 10-percent DMSO or 5-percent DMSO on the cryopreservation of CB MNCs or nucleated cells (NCs) were further evaluated. The read-out system consisted of a panel of HPCs: early progenitors (CFU-GEMM, long-term culture-initiating cells [LTC-IC]) and committed progenitors (CFU-GM, CFU/BFU-E, CFU-megakaryocyte [CFU-MK]). The homing and engraftment capacity of these cells were assessed in nonobese diabetic (NOD)-SCID mice. RESULTS: Trehalose increased the recoveries of CFU-GM, CFU/BFU-E, CFU-GEMM, and LTC-IC by over 7.25 percent (mean), 11.9 percent, 19.2 percent, and 12.9 percent, respectively, when compared with those in paired CB samples cryopreserved in 10-percent DMSO. Freezing and thawing reduced the yields of CFU-MK by 35.5 percent (mean) and 28.4 percent in MNC and NC samples, respectively, and the inclusion of 5-percent trehalose significantly retrieved these progenitor cells to over 90 percent of fresh samples. The improved recovery of functional HPLs was reflected by their multilineage engraftment in NOD-SCID mice. CONCLUSION: Trehalose at 5 percent significantly ameliorates the cryopreservation of CB progenitor cells at a preclinical protocol. The increased recoveries of these cells might potentially improve the engraftment outcomes of CB transplants.     

Application of whole blood and peripheral blood progenitor cells (PBPC) and new strategies for rescue after intensive cyclic chemotherapy in high-risk breast cancer

The efficacy of autologous peripheral stem cells given as mobilized whole blood or leukapheresis product for hematopoietic rescue after intensive chemotherapy was studied in 34 consecutive female patients with high-risk breast cancer. All patients received six cycles of chemotherapy regimen EC (epirubicin 150 mg/m2 and cyclophosphamide 1250 mg/m2) at 14-day intervals. In the first cycle, chemotherapy was given on day 1, and 24 h later mobilization of PBPC was started with G-CSF at a dose of 5 microg/kg/day for 13 days. In all other cycles, G-CSF was given at the same dose from day 7. On days 11, 12, and 13, leukaphereses were performed, and whole blood was collected on day 14 (the peak incidence of colony-forming units-granulocyte-macrophage [CFU-GM] burst-forming units-erythrocyte [BFU-E], and colony-forming unit-granulocyte-erythrocyte-macrophage-megakaryocyte [CFU-GEMM]). The second cycle of chemotherapy was started on day 15, and 24 h later, whole blood (collected in the first cycle) was reinfused, and the same was done in the third cycle. In the fourth to sixth chemotherapy cycles, leukapheresis product was used for hematopoietic rescue. The median increment of absolute values in both whole blood and leukapheresis product was as follows: CD34+ cells over baseline was approximately 17.4-fold, CFU-GM was 85.3-fold, BFU-E was 95.9-fold, and CFU-GEMM was 44.2-fold. In the cycles with whole blood support, the mean values of applied progenitors per cycle were CD34+ cells 1.52 x 10(6)/kg, CFU-GM, 1.18 x 10(5)/kg, BFU-E 2.54 x 10(5)/kg, CFU-GEMM 0.31 x 10(5)/kg. In the courses with PBPC support, the mean values of progenitors were CD34+ 2.04 x 10(6)/kg, CFU-GM 1.59 x 10(5)/kg, BFU-E 2.87 x 10(5)/kg, and CFU-GEMM 0.34 x 10(5)/kg. Leukopenia in patients supported with whole blood versus leukapheresed PBPC was as follows: grade 4, 13/6 (38.2%/17.6%), grade 3, 19/23 (55.9%/70.6%), and grade 2, 1/4 (2.9%/11.8%), respectively. Thrombocytopenia was grade 4, 11/6 (32.4%/17.6%), grade 3, 10/7 (29.4%/20.6%), grade 2, 7/13 (20.6%/38.2%), and grade 1, 6/6 (17.6%/17.6%), respectively. The median follow-up analysis was at 24.6 (7-36) months. High-risk patients previously treated with surgery and adjuvant chemotherapy (n = 5) were not evaluated for response. In 21 patients with locally advanced or inflammatory breast carcinoma the response rate (RR) was 94%, CR was 90%, and PR was 15%. No response to therapy was observed in 1 patient. In 8 patients with metastatic disease, RR was 75%, there was no CR, and PR was 75%. Two patients died during therapy. Relapse-free survival (RFS) in the adjuvant group was 23.7 (range 12-36) months and in the group with locally advanced disease was 18.2 (range 7-27) months. In the group with metastatic disease, time to tumor progression (TTP) was 12.1 (range 1-16) months. Mean duration of hospital stay for whole blood reinfusion in the second and third chemotherapy cycles was 6.7 (range 5-8) days and for PBPC in the fourth to sixth cycles was 6.2 (range 4-8) days, which at p < 0.001 was not statistically significant.     

Hematopoietic recovery in cancer patients after transplantation of autologous peripheral blood CD34+ cells or unmanipulated peripheral blood stem and progenitor cells

BACKGROUND: A study of CD34+ cell selection and transplantation was carried out with particular emphasis on characteristics of short- and long-term hematopoietic recovery. STUDY DESIGN AND METHODS: Peripheral blood stem and progenitor cells (PBPCs) were collected from 32 patients, and 17 CD34+ cell-selection procedures were carried out in 15 of the 32. One patient in whom two procedures failed to provide 1 × 10(6) CD34+ cells per kg was excluded from further analysis. After conditioning, patients received CD34+ cells (n = 10, CD34 group) or unmanipulated (n = 17, PBPC group) PBPCs containing equivalent amounts of CD34+ cells or progenitors. RESULTS: The yield of CD34+ cells was 53 percent (18–100) with a purity of 63 percent (49–82). The CD34+ fraction contained 66 percent of colony-forming units-granulocyte- macrophage (CFU-GM) and 58 percent of CFU of mixed lineages, but only 33 percent of burst-forming units-erythroid (BFU-E) (p < 0.05). Early recovery of neutrophils and reticulocytes was identical in the two groups, although a slight delay in platelet recovery may be seen with CD34+ cell selection. Late hematopoietic reconstitution, up to 1.5 years after transplant, was also similar. The two groups were thus combined for analyses of dose effects. A dose of 40 × 10(4) CFU-GM per kg ensured recovery of neutrophils to a level of 1 × 10(9) per L within 11 days, 15 × 10(4) CFU of mixed lineages per kg was associated with platelet independence within 11 days, and 100 × 10(4) BFU-E per kg predicted red cell independence within 13 days. However, a continuous effect of cell dose well beyond these thresholds was apparent, at least for neutrophil recovery. CONCLUSION: CD34+ cell selection, despite lower efficiency in collecting BFU-E, provides a suitable graft with hematopoietic capacity comparable to that of unmanipulated PBPCs. In both groups, all patients will eventually show hematopoietic recovery of all three lineages with 1 × 10(6) CD34+ cells per kg or 5 × 10(4) CFU-GM per kg, but a dose of 5 × 10(6) CD34+ cells or 40 × 10(4) CFU-GM per kg is critical to ensure rapid recovery.     

特发性血小板减少性紫癜骨髓造血干细胞的功能及与疗效的关系

目的：探讨特发性血小板减少性紫癜（idiopathic thrombocytopenic purpura,ITP)患者骨髓造血干细胞的增殖分化功能，并从巨核细胞集落形成单位和数量和血小板上升的幅度探讨两者之间的疗效关系。方法：用甲基纤维半固体培养ITP患者粒－巨噬细胞集落形成单位、红系集落形成单位、巨核细胞集落形成单位，观察巨核细胞集落形成单位与血小板上升平均值的关系。结果：ITP患 者骨髓粒－巨噬细胞集落、红系集落形成单位，巨核细胞集落形成单位集落数低于正常对照组，粒－巨噬细胞集落及丛落数高于政党对照组，巨核细胞数大于5／高倍视野的ITP患者其巨核细胞数与血小板上升无关，巨噬细胞集落形成单位与血小板上升平均值有。结论：ITP患者骨髓造血干细胞增殖分化功能异常，提示ITP可能是造血干细胞异常的疾病。ITP的巨噬细胞集落形成单位与血小板上升幅度有关，巨噬细胞集落形成单位可以预测ITP的治疗效果。     

短程大剂量粒细胞集落刺激因子动员外周血造血干细胞的研究

研究短程大剂量粒细胞集落刺激因子对外周血造血干细胞的动员作用。方法采用短程大剂量Ｇ－ＣＳＦ对１１例患者进行外周血造血干细胞动员，Ｇ－ＣＳＦ５μｇ／ｋｇ皮下注射，每日２次，共３天，动员当天及第４天，分别取骨髓及外周血增生明显活跃，外周血白细胞计数明显升高。