多发性骨髓瘤患者外周血造血干细胞动员的临床分析

目的:探讨多发性骨髓瘤(MM)患者使用化疗联合粒细胞集落刺激因子(G-CSF)进行外周血造血干细胞动员的效果及影响因素.方法:将20例MM患者检测采集物中有核细胞数及CD34+细胞数量进行回顾性分析.结果:20例患者共经过44例次单采,自化疗结束至采集日平均时间为10.55(8～14)天.获得有核细胞均数为6.01×108/kg(1.67～14.7×108/kg),CD34+细胞12.49×106/kg(1.9～38×106/kg).仅有2例患者采集物CD34+细胞＜2.5×106/kg.对比两组的临床特征,发现CD34+细胞产率与病程,动员前化疗次数,外周血白细胞恢复时间相关,而与年龄、性别、疾病状态等因素无明显相关性.结论:化疗联合G-CSF方案应用于MM患者中,绝大多数能获得足够的干细胞,对于病程长,化疗次数多动员后血象恢复时间长的患者效果不佳.

Clinical analysis of mobilization of autologous peripheral blood stem cells in patients with multiple myeloma

Objective：To investigate the efficacy and influential factors of the mobilization of peripheral blood stem cells（PBSCs） with combination of cyclophophamide or etoposide and recombinant human granulocyte colony-stimulating factor（rhG-CSF） in the patients with multiple myeloma.Methods：PBSCs were mobilized with chemotherapy combined with rhG-CSF and collected by leukapheresis.The amounts of mononucleated cells（MNCs） and CD34＋ cells were counted by flow cytometry.Results：Twenty patients underwent 44 leuka-pheresises,the median time from the ending of chemotherapy to the beginning of apheresis was 10.55 d（8-14 d）.The median number of MNCs and CD34＋ cells were 6.01×10^8/kg（1.67×10^8-14.7×10^8/kg） and 12.49×10^6/kg（1.9×10^6-38×10^6/kg） respectively.Two patients failed to obtain adequate PBSCs.Conclusion：It is effective and safe to mobilize PBSCs by combination of cyclophosphamide or etoposide and rhG-CSF for most patients with multiple myeloma,the patients with long period of disease and high Drake’s scores could fail to gain adequate PBSCs.