CD34~+ CD38~-细胞对异基因造血干细胞移植的影响研究

目的观察CD34+CD38-细胞对异基因造血干细胞移植术后造血重建和移植物抗宿主病(GVHD)的影响。方法分析2004年1月至2009年12月河南省人民医院血液科全相合异基因外周血干细胞造血干细胞移植78例,CD34+、CD34+CD38-细胞输入量与血缘全相合异基因外周血造血干细胞移植术后造血重建及GVHD发生率间的相关性。结果粒细胞、血小板恢复时间与CD34+CD38-细胞输入量呈负相关(r分别为-0.521、-0.448,P<0.01),与CD34+细胞输入量也呈负相关(r分别为-0.405、-0.371,P<0.05)。急性GVHD、慢性GVHD的发生与CD34+、CD34+CD38-、CD3+、CD4+、CD8+细胞输入量无相关性。结论输入高数量的CD34+CD38-细胞有利于移植术后的粒细胞、血小板快速恢复;对于预测术后造血恢复,CD34+CD38-细胞亚群输入量可能优于CD34+细胞总数。

Impact of CD34~+ CD38~- cells on allogeneic peripheral blood stem cell transplantation

Objective To evaluate the impact of CD34+CD38-subsets on engraftment kinetics and the incidence of graft versus host diseases(GVHD)in allogeneic peripheral blood stem cell transplantation(Allo-PBSCT). Methods The relationship among the number of total CD34+ cells and CD34+CD38-cells infused,early neutrophil and platelet engraftment and incidences of GVHD after Allo-PBSCT were studied. Results The CD34+CD38-cell number was inversely correlated with the days required for the recovery of 0.5× 109/L neutrophils(r=-0.521,P<0.01)and platelets of 20 × 109/L(r=-0.448,P<0.01);this correlation was better than it was between the total CD34+ cell dose and neutrophil(r=-0.405,P<0.01)and platelet engraftment(r=-0.371,P<0.05).No correlation was found between incidences of GVHD and the number of total CD34+ cells and CD34+CD38-cells infused. Conclusion A high number of CD34+CD38-cell may be associated with faster neutrophil and platelet recovery.The CD34+CD38-subset is better than the total CD34+ cell dose as a predictor for early neutrophil and platelet engraftment.