异基因外周血干细胞的动员,检测及临床移植的应用研究

目的：探讨异基因外周血干细胞移植（ａｌｌｏ－ＰＢＳＣＴ）供者经Ｇ－ＣＳＦ或Ｇ－ＣＳＦ＋ＧＭ－ＣＳＦ动员后，采集的外周血干细胞（ＰＢＳＣ）移植物中的幼稚粒细胞与单个核细胞（ＭＮＣ）、ＣＤ３４＾＋细胞及ＣＦＵ－ＧＭ之间的相关性和移植的剂量标准及临床应用效果。方法：对１１例ａｌｌｏ－ＰＢＳＣＴ供者用Ｇ－ＣＳＦ（９例）或Ｇ－ＣＳＦ＋ＧＭ－ＣＳＦ（２例）进行动员，于动员前及动员后，分别对外周血及ＭＮＣ惧物中的幼稚粒细胞、ＣＤ３４＾＋细胞及ＣＦＵ－ＧＭ进行检测计数，预处理方法主要用大剂量环磷酰胺（ＣＴＸ）＋全身照射（ＴＢＩ）。结果：动员后外周血中的幼稚粒细胞与ＣＤ３４＾＋细胞及ＣＦＵ－ＧＭ同步增加，外周血ＭＮＣ中的幼稚粒细胞数与ＣＤ３４＾＋细胞数及ＣＦＵ－ＧＭ有较好的相关性。１１例患者全部植活和恢复造血功能，并为染色体核型

A study of mobilization, measurement and application of clinical transplantation of allogeneic peripheral blood stem cells

Objective: To study the correlation among the immature granulocyte, mononuclear cells (MNC), CD 34 \ cell and CFU GM in collected peripheral blood stem cell (PBSC) as well as the dosage standard and effect of clinical application of allogeneic PBSC transplantation (allo PBSCT) after the donors were mobilized by G CSF or G CSF GM CSF. Methods: Eleven donors of allo PBSCT were mobilized by G CSF (9 cases) or G CSF plus GM CSF (2 cases). Before and after mobilization, measurements of the count of immature granulocyte CD 34 \ cell and CFU GM in collected MNC and peripheral blood was performed. The conditioning regimen mainly consisted of cyclophosphamide and total body irradiation. Result: after mobilization, the immature granulocyte and CD 34 \ cell count and CFU GM increased simultaneously in peripheral blood. The immature granulocyte count in peripheral blood MNC was well correlated to the CD 34 \ cell and CFU GM. All patients were engrafted and got hematopoietic reconstitution, and complete donor engraftment documented by which the chromosome keryotype or blood type were changed to that of the donors. Conclusion: After the donors were mobilized by G CSF or G CSF GM CSF, the immature granulocyte count of MNC in peripheral blood was well correlated to the CD 34 \ cell and CFU GM, so, the combination of immature granulocyte and MNC can be the dosage standard of allo PBSCT. This method was quick, stable, and conveninent. Allo PBSCT can rapidly reconstitute hematopoiesis.