急性白血病异基因外周血造血干细胞移植血缘供者安全性分析

目的：探讨急性白血病异基因外周血造血干细胞移植血缘供者近期的不良事件及远期的安全性。方法185例急性白血病异基因外周血造血干细胞移植血缘供者，干细胞动员后，用COBE Spectra血细胞分离机采集外周血干细胞。检测供者动员时血常规及形态学分类、CD34＋细胞百分比、干细胞混悬液中单个核细胞（ MNC）数量及CD34＋细胞计数，同时记录供者动员和采集过程中的不良事件、采集后第1、3、7天血常规变化及长期随访。结果血缘供者干细胞动员前白细胞计数为（6.16±1.58）x 109·L-1，采集时白细胞计数为（41.55±9.77）x109·L-1，是动员前6.75（4.18-10.87）倍。干细胞混悬液MNC为（247.61±105.99）x 108，CD34＋细胞为（3.54±3.42）x 108。动员时血缘供者的常见不良事件有头痛、腰背困痛、四肢痛、全身痛，合计占94.6%；外周血干细胞采集过程中，静脉持续输注葡萄糖酸钙，供者口周和指尖麻木等低钙症状发生率为3.2%；所有供者的不良事件均可耐受，无一例供者因不良事件终止干细胞动员或采集。供者干细胞采集后1周血象基本恢复正常；随访11 a血缘供者健康状况良好，无与动员及采集相关的远期并发症发生。结论急性白血病异基因外周血造血干细胞移植血缘供者动员采集无明显的近期不良事件及远期并发症，安全性非常高，为非血缘移植供者提供可靠的安全保障依据，减少恐惧感，降低反悔率。

Safety of Related Donors by Allogeneic Peripheral Blood Hematopoietic Stem Cell Transplantation in Acute Leukemia

Objective To explore the immediate adverse events and long-term safety of related donors by alloge-neic peripheral blood hematopoietic stem cell transplantation in acute leukemia. Methods One hundred and eighty-five related donors by allogeneic peripheral blood hematopoietic stem cell transplantation in acute leukemia had been mobilized and collected the stem cells,recorded the immediate adverse events during mobilization and collection and long-term follow-up after mobilization and collection. The blood routine,morphology classification,CD34＋ cell per-centage,number of mononuclear cells（ MNC）,CD34＋ cells were detected during mobilization. Results The num-ber of white blood cell of related donors after mobilization significantly increases by 6. 75（4. 18-10. 87）times [（6. 16 ± 1. 58）x 109 ·L-1 vs（41. 55 ± 9. 77）x 109 ·L-1 ]. In the stem cells suspension,the count of MNC and CD34 ＋ is（247. 61 ± 105. 99）x 108 and（3. 54 ± 3. 42）x 108 respectively. The common adverse events were head-ache,back pain,limb pain during related donor mobilization,add up to 94. 6%;the incidence of low calcium symp-tom（perioral or finger tip numbness）of related donors was 3. 2% in the mobilization and collection;all the adverse events in the mobilization and collection could be tolerated. Blood counts of related donors after stem cells collection returned to normal in a week;related donors follow-up in 11 years had no long-term complications associated with the mobilization and collection in good health. Conclusion There are no seriously immediate adverse events and long-term complications in the related donors by allogeneic peripheral blood hematopoietic stem cell transplantation in the acute leukemia during and after mobilization and collection,which provides reliable security basis and reduces the rate of prosecution history estoppel for unrelated donors.