恶性血液系统疾病自体外周血造血干细胞动员的临床分析

目的:分析恶性血液系统疾病患者外周血造血干细胞动员与采集过程中的影响因素。方法:对50例血液系统恶性疾病患者在东南大学附属中大医院血液科进行外周血造血干细胞动员。对患者年龄、性别、动员方案、疾病状态、采集机器等因素进行分析,评估以上因素对干细胞动员结果的影响,并分析了采集前白细胞、血红蛋白、血小板的数量与采集的CD34^+细胞计数的相关性。结果:动员方案对CD34^+细胞采集数及CD34^+细胞采集成功率的影响有显著性影响,而性别、年龄、确诊到动员间隔时间、既往化疗方案、骨髓受累与否等对干细胞采集数量影响并不显著。采集前外周血白细胞数量及血红蛋白数量与采集的CD34^+细胞数呈正相关。采集前外周血中白细胞计数及单个核细胞计数与采集成功密切相关。结论:化疗联合细胞因子的动员方案采集造血干细胞优于单用细胞因子的动员方案。通过采集前白细胞计数及单个核细胞计数确定合适的采集时机,可以提高采集的成功率。

Clinical Analysis of Autologous Peripheral Blood Hematopoietic Stem Cell Mobilization Regimen in Patients with Malignant Hematological Diseases

Objective:To analyze the factors influencing the mobilization and collection of peripheral blood hematopoietic stem cells(HSC)in the patients with malignant hematological diseases.Methods:The peripheral blood stem cells in 50 patients with hematological malignancies had been mobilized in the Hematology Department Zhongda Hospital.The factors,such as age,sex,mobilization regimen,disease status,cell separator were analyzed,and the effect of above-mentioned factors on stem cell mobilization was evaluated.And the correlation between WBC,Hb,Plt counts and CD34^+cell collection was anzlyzed.Results:There was significant effect at mobilization regimen on the success rate and collection counts of CD34^+cells,while sex,age,interval between diagnosis and mobilization,previous chemotherapy regimen and bone marrow involvement showed no significant effect on stem cell collection.There was positively correlation of the WBC count,hemoglobin level of peripheral blood before apheresis with the collection of CD34^+cells.The WBC and MNC counts in peripheral blood before apheresis closely related with the success rate of mobilization.Conclusion:Chemotherapy plus combined with G-CSF mobilization regimens is superior to mobilization regimen of cytokine alone for collection of HSC.The WBC and MNC count in peripheral blood before apheresis can predict the optimal time for the PBSC collection and increase the success rate of mobilization and collection.