低剂量rhG-CSF对56例非血缘供者外周造血干细胞动员

本研究观察低剂量人重组粒细胞集落刺激因子(rhG-CSF)对非血缘健康供者的影响,探讨用于中华造血干细胞捐赠者资料库提供的非血缘健康供者外周造血干细胞动员方案。56例非血缘健康供者接受rhG-CSF 5μg/(kg.d)皮下注射,在动员第4、5两天或第5、6两天采集干细胞,观察动员效果及不良反应,检测动员前后血常规指标、CD3+、CD4+、CD8+和CD20+细胞比例;对采集物进行单个核细胞(MNC)和CD34+细胞计数;对所有供者随访至2006年5月31日。结果显示:在rhG-CSF动员过程中出现1级毒副作用(按WHO分级标准):腰背酸痛17.9%(10/56)、焦虑失眠8.9%(5/56)、疲乏4.5%(3/56)等,无需特殊处理,无需终止动员。第4、5两天采集和第5、6两天采集所得的MNC分别是(5.95±1.52)×108/kg和(7.19±2.12)×108/kg;CD34+细胞分别是(3.03±1.09)×106/kg和(7.92±2.50)×106/kg。血红蛋白水平、血小板量、CD3、CD4、CD8、CD20百分比动员前后无变化。结论:5μg/(kg.d)rhG-CSF用于非血缘健康供者的动员是安全而有效的。

Peripheral Blood Stem Cell Mobilization with Low Dose rhG-CSF in 56 Unrelated Healthy Donors

The study was aimed to observe the effect of recombinant human granulocyte-colony stimulating factors (rhG-CSF) in low dose on peripheral blood stem cell (PBSC) mobilization in unrelated healthy normal donors. G-CSF was administered at 5 microg/(kg x d) subcutaneously for successive 5 or 6 days to 56 unrelated donors. Stem cells were harvested on the fourth and fifth days or on the fifth and sixth days. The numbers of mononuclear cells (MNC), CD34(+) cells and Hb, Plt, and CD3(+), CD4(+), CD8(+) and CD20(+) cells were determined during the mobilization. The results showed that most common adverse events were bone pain (17.9%, 10/56), agrypnia (8.9%, 5/56) and lassitude (4.5%, 3/56) during rhG-CSF mobilization, but all donors were suffered less than grade II according to the WHO criteria, and did not need to stop the mobilization and not need to give special treatment. In harvest on day 4 - 5 and 5 - 6, MNC count was (5.95 +/- 1.52) x 10(8)/kg and (7.19 +/- 2.12) x 10(8)/kg; CD34(+) cells count was (3.03 +/- 1.09) x 10(6)/kg and (7.92 +/- 2.50) x 10(6)/kg. There were no significant differences in hemoglobin level and platelet count, the percentage of CD3(+) cells, CD4(+) cells, CD8(+) cells and CD20(+) cells between pre-mobilization and post-mobilization of rhG-CSF. It is concluded that the low dose of rhG-CSF 5 microg/(kg x d) for peripheral blood stem cell mobilization in unrelated healthy normal donors is safe and effective.