非血缘异基因外周血造血干细胞动员与采集的效果及安全性评价

目的 评价非血缘异基因外周血造血干细胞动员与采集的效果及安全性.方法 按照中华造血干细胞资料库制定的非血缘异基因干细胞动员方案,结合移植医院的动员要求及捐献者的体质情况制订合理的干细胞动员方案,对山西医科大学第二医院2012年5月至2017年1月行非血缘异基因外周血造血干细胞采集的64名健康供者,采用动员剂粒细胞集落刺激因子(G-CSF)5～10μg·kg-1·d-1,单次或分次皮下注射,3～4 d后使用COBE Spectra血细胞分离机进行外周血造血干细胞采集.对不同年龄、性别供者的动员、采集效果及不良反应进行分析.结果3 d或4 d动员方案均可达到采集要求,采集的单个核细胞数≥5.0×108/kg,CD34阳性细胞数≥2.0×106/kg.单次采集成功率(采集的单个核细胞及CD34阳性细胞数达标)为65％,采集效率为52％,可降低患者费用及供者的风险.年轻、体质好的供者采集的干细胞质量高于年龄偏大者.16名(25％)供者出现轻度不良反应,无需特殊处理.结论非血缘异基因干细胞动员、采集是安全的.从节省医疗资源、更多关注供者利益出发,采用3 d或4 d动员方案提高单次采集成功率是可行的.采集过程中应做好供者低血钙症状的观察并给予相应的健康教育,以缓解供者的紧张情绪.

Efficacy and safety evaluation of mobilization and collection of unrelated allogeneic peripheral blood stem cells

Objective To evaluate the efficacy and safety of the mobilization and collection of unrelated allogeneic peripheral blood stem cells. Methods The suitable stem cell mobilization plan was made in accordance with the hematopoietic stem cell mobilization plan of China Marrow Donor Program, the ruler of the hospital, and the donor's constitution. The unrelated allogeneic peripheral blood stem cells of 64 healthy donors were collected in the second Hospital of Shanxi Medical University from May 2012 to January 2017. The donor was infected one or several times with the mobilization agent granulocyte colony stimulating factor (G-CSF) by 5-10 μg·kg-1·d-1. After 3-4 days, peripheral blood hematopoietic stem cells were collected using COBE Spectra blood cell separator. Then, the effect and adverse reaction of donors were analyzed from different age and sex. Results It can achieve the acquisition requirements using 3 or 4 days of mobilization programs, mononuclear cells≥5.0×108/kg, CD34+cells≥2.0×106/kg. The single acquisition success rate (the target acquisition of the number of mononuclear cells and CD34+) up to 65 ％, collection efficiency reached 52％, which could reduce the risk of donor and the cost of patients. The quality of donor stem cell of young was better than that of older persons. Sixteen donors (25％) had mild adverse reactions, and no special treatment was required. Conclusions Allogeneic stem cell mobilization is safe. Starting from save medical resources and the interests of the donor the 3 day or 4 days of mobilization scheme could improve the success rate of the single mobilization. During the collection process, the condition of donor hypocalcemia should be observed and health education should be given to relieve the tension of donor.