rhG-CSF动员的骨髓和外周血干细胞混合移植物首次采集时供者外周血单核细胞计数反映混合采集物中CD34^＋细胞含量

本研究探讨人重组粒细胞集落刺激因子（rhG-CSF）动员的骨髓和外周血干细胞混合移植健康供者首次干细胞采集时供者外周血单核细胞数量与骨影外周血混合采集物中CD34^＋细胞数量的关系。对70名亲缘健康供者均皮下注射rhG-CSF5μg／（kg·d），连续5天。第4天和第5天分别采集骨髓和外周血干细胞。首次干细胞采集时用EX2100血细胞分析仪检测供者外周血细胞计数，同时应用流式细胞仪测定骨髓和外周血混合采集物中的CD34^＋细胞数量。结果表明：rhG—CSF动员的70例供者首次干细胞采集时外周血单核细胞的数量为（1．15±0．60）×10^9／L；骨髓和外周血采集物中的CD34^＋细胞总量分别是（5．854±2．93）×10^7和（1．33±0．77）×10^8；骨髓和外周血混合采集物的CD34^＋细胞总量是（1．92±0．86）×10^8。Pearson和Spearman分析显示首次干细胞采集时供者外周血单核细胞计数（×10^9／L）与骨髓采集物中CD34^＋细胞的总量（相关系数：r=0．265，P=0．027）、外周血采集物中CD34^＋细胞总量（r=0．340，P=0．004）以及混合移植物中CD34^＋细胞的总量（r=0．398，P：0．001）均存在显著的相关性；多因素分析表明，首次干细胞采集时供者外周血单核细胞计数与骨髓采集物、外周血采集物以及混合移植物中CD34^＋细胞的总量均呈正相关关系（P值分别为0．027、0．004和0．001）。首次干细胞采集时供者外周血单核细胞数量对混合移植物中CD34^＋细胞总量预测的敏感性是71％，特异性是70％（P=0．007）。结论：rhG-CSF动员的骨髓和外周血混合移植健康供者首次干细胞采集时外周血单核细胞计数可有效预测输注给受者的CD34^＋细胞总量即采集效果。

Peripheral Monocyte Counts at First Collection of Allo-grafts Predicts Amount of CD34+ Cells in Mixture of rhG-CSF Primed Bone Marrow and Mobilized Peripheral Stem Cell Grafts

This study was purposed to investigate the relation of monocyte counts in peripheral blood （PB） at the first collection of allograft to the amount of CD34^＋ cells in the mixture of recombinant human granulocyte colony-stimu- lating factor （rhG-CSF）- primed bone marrow graft （G-BM） and rhG-CSF mobilized peripheral stem cell grafts （G-PB）. 70 healthy donors were treated with rhG-CSF 5 μg/（kg·d）] injected subcutaneously for 5 consecutive days. Bone marrow grafts and peripheral blood grafts were harvested on the 4th and 5th days respectively. Blood cell counts at the first collection of allografts were determined by blood analyzer XL2100, the amount of CD34^＋ cells in G-BM and G- PB were determined by flow cytometry. The results showed that the monocyte counts in the PB of the 70 healthy donors were （1.15± 0.60） × 10^9/L. The amount of total CD34^＋ cells in the G-BM, G-PB and mixture grafts were （5.85±2. 93）× 10^7, （1.33±0.77）× 10^8, and （ 1.92±0.86）×10^8 respectively. Pearson and Spearman correlation analysis indicated that the counts of monocyte at the first collection of allografts correlated positively with the amount of total CD34^＋ cells in the G-BM （ correlation coefficient, r = 0. 265 ,p = 0. 027 ）, G-PB （ r = 0. 340 ,p = 0. 004） and mixture grafts （r =0. 398, p =0.001 ）. Stepwise Linear Regression Model analysis also showed that the counts of monocyts in the PB correlated positively with the amount of CD34^＋ cells in the G-BM, G-PB and mixture grafts （p =0.027, 0.004 and 0.001 respectively）. The sensitivity and specificity of the monocyte counts to predict the amount of CD34^＋ cells in the mixture grafts were 71% and 70% respectively （p =0.007）. In conclusion, the monocyte counts in the PB at the first collection of allografts after rhG- CSF treatment of healthy donors may be a simple and practical indicator for harvest of CD34^＋ cell amount in the mixture grafts.