组胺 H_2 受体阻滞剂阻断再生障碍性贫血患者 CD_8~ 细胞抑制正常 CFU-GM 生长的作用

目的：探讨再生障碍性贫血（再障）患者ＣＤ８＋细胞的组胺Ｈ２受体在造血抑制中的作用。方法：在１７例正常人粒－巨噬细胞集落（ＣＦＵ－ＧＭ）培养体系中分别加入１７例再障患者外周血ＣＤ８＋细胞，再障患者外周血ＣＤ８＋细胞＋甲氰咪胍和单加甲氰咪胍。结果：再障患者外周血ＣＤ８＋细胞在体外能抑制正常人骨髓细胞ＣＦＵ－ＧＭ的生长，０．５×１０－５ｍｏｌ／Ｌ和１．０×１０－５ｍｏｌ／Ｌ的甲氰咪胍均能解除这种抑制作用。１．０×１０－５ｍｏｌ／Ｌ甲氰咪胍本身可使正常人骨髓细胞ＣＦＵ－ＧＭ的产率有所下降，但０．５×１０－５ｍｏｌ／Ｌ甲氰咪胍对正常人骨髓细胞ＣＦＵ－ＧＭ的生长无抑制作用。结论：组胺Ｈ２受体阻滞剂甲氰咪胍在体外能解除再障患者ＣＤ８＋细胞对正常ＣＦＵ－ＧＭ生长的抑制作用。     

骨髓增生异常综合征GM－CFU和L－CFU的临床意义

本文对３０例ＭＤＳ患者进行骨髓ＧＭ－ＣＦＵ和Ｌ－ＣＦＵ培养，并与３０例再障、４４名正常人作对照比较，ＭＤＳ的ＲＡ组ＧＭ－ＣＦＵ集落低于正常对照组，集丛和丛／落比均高于正常人，Ｐ＜０．００１。但集落、集丛和丛／落比高于再障，Ｐ＜０．００１。再障组集落和集丛则低于正常人，Ｐ＜０．００１，丛／落比高于正常人，Ｐ＜０．００１。Ｌ－ＣＦＵ培养ＭＤＳ集落多于正常组和再障，Ｐ＜０．０５，再障则与正常人无差异性。所以，ＧＭ－ＣＦＵ和Ｌ－ＣＦＵ培养可以作为ＭＤＳ的ＲＡ与再障鉴别的一项实验室检查，并且对ＭＤＳ的预后判断有一定临床价值。     

组胺H2受体阻滞剂对免疫介导小鼠再生障碍性贫血发生的？…

目的 探讨组胺Ｈ２受体阻滞剂对免疫介导小鼠再生障碍性贫血（再障）的发生有无阻断作用。方法 通过给全身亚致死量照射的ＢＡＬＢ／ｃ小鼠转输Ｈ－２相同、ＭＬＳ不同的ＤＢＡ／２小鼠胸腺、淋巴结混合细胞诱导小鼠再障发生,实验组每天腹腔注射１次甲氰咪胍,共８次,于照射后第１４天,观察股骨骨髓增生程度。结果 腹腔注射０．５０,１．００,２．００ｍｇ．（１０ｇ体重）＾－１,ｄ＾ －１甲氰咪胍的小鼠的股骨平均骨髓造     

组胺H2受体阻滞剂对再生障碍性贫血患者CD8+细胞抑制正常BFU-E生长的影响

由于抑制性Ｔ淋巴细胞不仅具有ＣＤ８抗原,而且还具有组胺Ｈ２受体［１］,为了解再生障碍性贫血（再障）患者ＣＤ８＋细胞对造血的影响及其组胺Ｈ２受体在红系造血抑制中的作用,我们观察了再障患者ＣＤ８＋细胞对正常红系爆式集落（ＢＦＵＥ）生长的作用以及组胺Ｈ２受体阻滞剂甲氰咪胍对此种作用的影响,现报道如下。病例和方法１　病例　再障患者１３例。其中男１１例,女２例;年龄１６～６１岁;重型再障（ＳＡＡ）Ⅰ型３例,ＳＡＡⅡ型２例,慢性再障８例,诊断均符合文献［２］标准。２　试剂　甲氰咪胍系美国Ｓｉｇｍａ公司产…     

骨髓增生异常综合征GM—CFU和L—CFU的临床意义

本文对３０例ＭＤＳ患者进行骨髓ＧＭ－ＣＦＵ和Ｌ－ＣＦＵ培养，并与３０例再障，４４名正常人作对照比较，ＭＤＳ的ＲＡ组ＧＭ－ＣＦＵ集落低于正常对照组，集丛和丛／落比均高于正常人，Ｐ〈０．００１，但集落，集丛和丛／落比高于再障，Ｐ〈０．００１。再障组集落和集丛则低于正常人，Ｐ〈０．００１，丛／落比高于正常人，Ｐ〈０．００１。Ｌ－ＣＦＵ培养ＭＤＳ集落多于正常组和再障，Ｐ〈０．０５，再障则与正常人无差异性，     

紫外线照射自血回输对脑梗塞患者外周血淋巴细胞亚群和血浆纤维连…

对２４例脑梗塞患者紫外线照射自血回输（ＵＢＩＯ）治疗前、后外周血淋巴细胞亚群及血浆纤维连接蛋白（Ｆｎ）含量变化进行了观察。结果ＵＢＩＯ治疗前脑梗塞患者外周血中总Ｔ细胞（ＣＤ３＾＋）、Ｔ抑制细胞（ＣＤ８＾＋）数均较正常人明显减少，ＣＤ４／ＣＤ８比值上升；Ｂ＾＋和人类白细胞抗原（ＨＬＡ－ＤＲ＾＋）细胞数增多；白细胞介素ＩＩ受体（ＩＬ－２Ｒ＾＋）和Ｔ辅助（ＣＤ＾＋）细胞数则与正常人无差异。血浆Ｆｎ含量低     

用PCR技术评价微量残留白血病细胞体外净化的效果

应用系列稀释法ＰＣＲ技术检测含５％携带ＰＣＲγ基因重排的ＣＣＲＦ－ＣＥＭ株细胞的模拟缓解期白血病骨髓的微量残留白血病细胞，敏感性为１０＾－＾５－１０＾－＾６水平。经ＶＰＬ加ＡＤＭ，Ｖｐ１６，ＶＣＲ联合体外净化１小时，结果显示有３个对数级的杀伤作用。用体外克隆形成培养法观察该联合方案对急性期白血病患者白病祖细胞集落，（ＣＦＵ－Ｌ）及正常骨髓造血干细胞集落（ＣＦＵ－ＧＭ）的抑制作用，ＣＦＵ－ＧＭ存活率     

再生障碍性贫血患者Fas抗原的表达及血浆可溶性Fas,FasL？…

目的 探讨Ｆａｓ（ＣＤ９５）／ＦａｓＬ（ＣＤ９５Ｌ）系统在再生障碍性贫血（再障）中的表达及临床意义。方法 用酶联免疫夹心法检测３２例再障患血浆可溶性Ｆａｓ,ＦａｓＬ（ｓＦａｓ,ｓＦａｓＬ）,用流式细胞术检测骨髓ＣＤ３４＾＋细胞,ＣＤ３４＾－细胞和外周血单个核细胞（ＰＢＭＮＣｓ）Ｆａｓ抗原的表达。结果 再障患骨髓ＣＤ３４＾＋细胞Ｆａｓ表达率显高于正常对照,且重型再障组较慢性再障组显增高,重型     

再生障碍性贫血患者骨髓T淋巴细胞的研究

目的：进一步探明免疫因素在再生障碍性贫血（再障）发病中的作用。方法：用碱性磷酸酶抗碱性磷酸酶法检测再障患者骨髓中Ｔ淋巴细胞表型的变化，并用半固体培养法检测再障患者骨髓及去Ｔ细胞后骨髓单个核细胞ＣＦＵ－ＧＭ集落形成情况。结果：①与正常对照组相比较，再障患者骨髓中Ｔ淋巴细胞百分率明显增高，且以ＣＤ８、ＣＤ２５细胞增多为主。②再障患者骨髓与外周血中Ｔ淋巴细胞的变化并不完全一致。在部分再障患者，仅骨髓中ＣＤ８细胞增多，外周血中不高。③再障患者骨髓ＣＦＵ－ＧＭ集落数及丛数明显低于正常对照组，去ＣＤ８细胞后，集落数及丛数均明显增加。结论：免疫异常是再障发病的重要因素，而且，骨髓中Ｔ淋巴细胞的变化比外周血更有意义。建议对再障患者常规检查骨髓中Ｔ淋巴细胞及其亚群的变化，以预测应用免疫抑制剂的可行性及其有效性。     

严重型再生障碍性贫血患者骨髓和外周血 HLA-DR~ T 细胞的变化及其淋巴细胞造血抑制活性的研究

目的：进一步阐明免疫紊乱在严重型再生障碍性贫血（ＳＡＡ）发病中的作用。方法：对１３例初诊ＳＡＡ、７例抗淋巴细胞球蛋白（ＡＬＧ）治疗后恢复期ＳＡＡ（ｒＳＡＡ）患者骨髓和外周血及对照组（包括９名骨髓对照和１１名外周血对照）的ＨＬＡ－ＤＲ＋Ｔ细胞进行检测，并对部分患者和对照组刺激的外周血去单核细胞的单个核细胞培养上清液（ＰＨＡ－ＬＹＣＭｓ）的造血活性进行检测。结果：初诊ＳＡＡ患者骨髓及外周血ＨＬＡ－ＤＲ＋Ｔ细胞显著高于对照组（Ｐ＜０．００１）；ＡＬＧ治疗后ｒＳＡＡ患者骨髓和外周血ＨＬＡ－ＤＲ＋Ｔ细胞较初诊ＳＡＡ下降，但仍高于对照组（Ｐ＜０．００１）；ＳＡＡ患者骨髓内ＨＬＡ－ＤＲ＋Ｔ细胞显著高于外周血（Ｐ＜０．００１）；与对照组比较，初诊的ＳＡＡ患者外周血ＰＨＡ－ＬＹＣＭｓ对正常骨髓ＢＦＵ－Ｅ和ＣＦＵ－ＧＭ具有显著的抑制作用（Ｐ＜０．００１），而ＡＬＧ治疗后ｒＳＡＡ患者ＰＨＡ－ＬＹＣＭｓ对正常骨髓ＢＦＵ－Ｅ和ＣＦＵ－ＧＭ的抑制作用明显减弱。结论：ＨＬＡ－ＤＲ＋Ｔ细胞在ＳＡＡ的发病中可能发挥重要的作用。     

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。     

化疗加G-CSF和GM-CSF联合动员自体外周血干细胞

目的　探讨化疗加粒细胞集落刺激因子 (G CSF)和粒 巨噬细胞集落刺激因子 (GM CSF)联合动员自体外周血干细胞 (APBSC)的效果。方法　卡铂 (CBP) 35 0mg m2 ,第 1天静滴 ;足叶乙甙(Vp16 ) 35 0mg m2 ,第 1～第 3天静滴 ;白细胞降至最低点又回升到 (2 .4～ 6 .4)× 10 9 L时 ,皮下注射G CSF 5 μg·kg- 1 ·d- 1 (早 6∶0 0 ) GM CSF 5 μg·kg- 1 ·d- 1 (晚 6∶0 0 ) 地塞米松 5mg d(采集日 10mg d)直到采集结束前 1天 ;白细胞上升到 (2 9.80± 5 .98)× 10 9 L ,开始用CS30 0 0plus血细胞分离机连续 2d采集APBSC。结果　 2 0例患者连续采集APBSC 2次 ,共采集到MNC(5 .93± 1.6 2 )× 10 8 kg ,CD34 细胞 (2 3.10± 11.5 3)× 10 6 kg ,CFU GM(3.44± 2 .85 )× 10 5 kg。无严重不良反应。 9例 10次自体外周血干细胞移植(APBSCT)造血功能均获满意重建。结论　以化疗联合G CSF和GM CSF能高效、安全地动员APBSC ,1次动员采集 2次可满足 1～ 2次的APBSCT。     

环磷酰胺联合重组人粒细胞集落刺激因子动员自体外周血干细胞

目的：观察环磷酰胺（ＣＴＸ）联合重组人粒细胞集落刺激因子对自体外周血干细胞（ＡＰＢＳＣ）的动员效果。方法：ＣＴＸ３．７±０．２ｇ／ｍ＾２第１天静滴，白细胞（ＷＢＣ）降至最低点时开始皮下注射ｒｈＧ－ＣＳＦ４．５±０．６μｇ．ｋｇ＾－１．ｄ＾－１，直至采集结束前一天，ＷＢＣ恢复至２．５×１０＾９／Ｌ以上时开始连日采集ＡＰＢＳＣ，采集用ＣＳ３０００ｐｌｕｓ或Ｃｏｂｅ血细胞分离机，当累计采集的单个核细胞（     

Prediction of engraftment after autologous peripheral blood progenitor cell transplantation: CD34, colony‐forming unit–granulocyte‐macrophage,or both?

BACKGROUND: The rate of hematologic recovery after peripheral blood progenitor cell (PBPC) transplantation is influenced by the dose of progenitor cells. Enumeration of cells that express CD34+ on their surface is the most frequently used method to determine progenitor cell dose. In vitro growth of myeloid progenitor cells (colony-forming unit-granulocyte-macrophage [CFU-GM]) requires more time and resources, but may add predictive information. STUDY DESIGN AND METHODS: A series of 323 patients, who underwent autologous PBPC transplantation for multiple myeloma, malignant lymphoma, or locally advanced breast cancer, were studied for the effect of CD34+ dose and CFU-GM dose on hematologic recovery. Measures for engraftment were days to absolute granulocyte and platelet (PLT) counts to greater than 500 per muL and than 20 x 10(9) per L, respectively, and number of PLT transfusions and red cell units required. RESULTS: The CD34+ dose had a median of 8.4 x 10(6) per kg, and the CFU-GM dose a median of 84.9 x 10(4) per kg. The CD34+ and CFU-GM doses showed significant correlation (R = 0.63; p < 0.0001) but a wide variation in the ratio of CD34+ and CFU-GM. Both CD34+ and CFU-GM doses had significant correlation with the measures of engraftment, but for all measures the relationship of CD34+ was stronger. Multivariate analysis and subgroup analysis of patients receiving CD34+ doses of less than 5 x 10(6) per kg also did not reveal an independent predictive value for CFU-GM. CONCLUSION: For prediction of hematologic recovery after autologous PBPC transplantation, determination of CFU-GM dose does not add to the predictive value of the CD34+ dose.     

Mobilization of peripheral blood stem cells with paclitaxel and rhG-CSF in high-risk breast cancer patients

Preclinical studies have demonstrated the rapid and efficient mobilization of hematopoietic peripheral blood stem cells (PBSC) in a mouse model using the combination of paclitaxel with recombinant human granulocyte colony-stimulating factor (rhG-CSF). On the basis of these results, a clinical trial was initiated using rhG-CSF with paclitaxel for PBSC mobilization in high-risk breast cancer patients. The mobilized PBSC were evaluated for CD34(+) cell number, mononuclear cell content, and clonogenic potential. One-hundred and seventeen breast cancer patients received paclitaxel (300 mg/m(2)) administered as a 24-h continuous intravenous infusion. Forty-eight hours after completing paclitaxel, rhG-CSF (5 microg/kg) was initiated and continued until completion of PBSC collection. Leukapheresis was initiated once the white blood cell count reached 1.0 x 10(9)/L. Each collection was evaluated for the numbers of mononuclear cells (MNC) and CD34(+) cells. Clonogenic potential was enumerated using colony-forming units-granulocyte-macrophage (CFU-GM) and burst-forming units-erythroid (BFU-E). Patients receiving paclitaxel with rhG-CSF mobilized a large number of mononuclear cells/apheresis (mean, 3.7 x 10(8); range, 3.3-4.1) and CD34(+) cells/apheresis (mean, 7.2 x 10(6); range, 6.1-8.4). The average number of leukophereses needed was 1.8 (mean, range 1.6-2.0). Colony growth was normal with 178.9 x 10(5) and 214.8 x 10(5) colonies counted in CFU-GM and BFU-E assays, respectively. Patients engrafted platelets and neutrophils on day 10 following transplantation. In conclusion, PBSC mobilization with paclitaxel and rhG-CSF results in a large number of mononuclear cells and CD34(+) cells with normal clonogenic potential. The cells engraft normally following high-dose chemotherapy and autologous stem cell transplantation in high-risk breast cancer patients. These results demonstrate that paclitaxel with rhG-CSF is an efficient mobilizing agent in high-risk breast cancer patients.     

Uncontrolled-rate freezing and storage at -80 degrees C, with only 3.5-percent DMSO in cryoprotective solution for 109 autologous peripheral blood progenitor cell transplantations

BACKGROUND: Although controlled-rate freezing and storage in liquid nitrogen are the standard procedure for peripheral blood progenitor cell (PBPC) cryopreservation, uncontrolled-rate freezing and storage at -80 degrees C have been reported. STUDY DESIGN AND METHODS: The prospective evaluation of 109 autologous PBPC transplantations after uncontrolled-rate freezing and storage at -80 degrees C of apheresis products is reported. The cryoprotectant solution contained final concentrations of 1-percent human serum albumin, 2.5-percent hydroxyethyl starch, and 3.5-percent DMSO. RESULTS: With in vitro assays, the median recoveries of nucleated cells (NCs), CD34+ cells, CFU-GM, and BFU-E were 60.8 percent (range, 11.2-107.1%), 79.6 percent (6.3-158.1%), 35.6 percent (0.3-149.5%), and 32.6 percent (1.7-151.1%), respectively. The median length of storage was 7 weeks (range, 1-98). The median cell dose, per kg of body weight, given to patients after the preparative regimen was 6.34 x 10(8) NCs (range, 0.02-38.3), 3.77 x 10(6) CD34+ cells (0.23-58.5), and 66.04 x 10(4) CFU-GM (1.38-405.7). The median time to reach 0.5 x 10(9) granulocytes per L, 20 x 10(9) platelets per L, and 50 x 10(9) reticulocytes per L was 11 (range, 0-37), 11 (0-129), and 17 (0-200) days, respectively. Hematopoietic reconstitution did not differ in patients undergoing myeloablative or nonmyeloablative conditioning regimens before transplantation. CONCLUSION: This simple and less expensive cryopreservation procedure can produce successful engraftment, comparable to that obtained with the standard storage procedure.     

异基因外周血造血干细胞移植治疗急性再生障碍性贫血--一例报告附文献复习

目的探索异基因外周血造血干细胞移植治疗急性再生障碍性贫血(再障)的疗效及其长期造血重建.方法1例急性再障患者,30岁,供者为其胞弟,HLA配型完全相合.动员方案G-CSF250?μg/d×6d.预处理方案环磷酰胺(CTX)50mg·kg-1·d-1×4d,抗胸腺细胞球蛋白(ATG)20mg·kg-1·     

Collection of mobilized blood progenitor cells for hematopoietic rescue by large-volume leukapheresis

BACKGROUND: Mobilized blood progenitor cells rapidly reconstitute hematopoiesis in patients after dose-intensive chemotherapy. However, optimal timing and methods of mobilized blood progenitor cell collection have yet to be fully defined. STUDY DESIGN AND METHODS: The utility of large-volume leukapheresis (LVL; > 15 L blood processed) in collecting target doses of mononuclear cells (7 × 10(8)/kg) for use in autologous hematopoietic rescue was investigated. LVL was begun at a standardized interval (14 days) after a course of limited chemotherapy and subsequent daily recombinant human granulocyte-macrophage-colony- stimulating factor administration to mobilize blood progenitor cells into the circulation. With each LVL procedure, mononuclear cells, colony-forming units-granulocyte-macrophage (CFU-GM), burst-forming units-erythroid, mixed colonies, total clonogenic progenitor cells, and CD34+ cells collected per kg of patient weight were counted. After high- dose chemotherapy and infusion of cryopreserved mobilized blood progenitor cells, the days needed for neutrophils to reach levels of > 0.5 × 10(9) per L and for platelets to reach levels of > 20 × 10(9) per L were recorded. RESULTS: In 14 previously treated cancer patients, an average of 28.9 +/? 4.9 L of blood was processed per LVL (n = 35) to collect medians of 2.5 × 10(8) mononuclear cells per kg (range, 1.0- 7.4), 14 × 10(4) CFU-GM per kg (0-208), 27 × 10(4) clonogenic progenitor cells per kg (0-370), and 2.8 × 10(6) CD34+ cells per kg (0- 112.5). Fifty-seven percent of patients (8/14) required one or two LVL procedures to collect adequate blood progenitor cells (range, 1–4). After dose-intensive chemotherapy, 13 patients received medians of 6.8 × 10(8) mononuclear cells per kg (range, 5.1-9.9), 53 × 10(4) CFU-GM per kg (9-208), and 12 × 10(6) CD34+ cells per kg (3.6-112.5). Rapid hematopoietic reconstitution occurred with 10 days (range, 8–12) and 9 days (6-15), respectively, for neutrophil and platelet recoveries. CONCLUSION: Scheduled LVL, beginning on Day 14 after the administration of granulocyte-macrophage-colony-stimulating factor following chemotherapy, is a convenient and efficient method of collecting blood progenitor cells. The mononuclear cells so obtained effected consistent and rapid hematopoietic reconstitution in a highly reproducible manner in a group of heavily treated patients.