地塞米松对G-CSF动员供体外周血干细胞及其移植受体造血功能恢复的影响 |
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引用本文: | 刘华胜,王晓宁,刘海波,刘心,贺鹏程,陈丽梅,习杰英,王孟昌,李静. 地塞米松对G-CSF动员供体外周血干细胞及其移植受体造血功能恢复的影响[J]. 中国实验血液学杂志, 2013, 0(5): 1232-1236 |
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作者姓名: | 刘华胜 王晓宁 刘海波 刘心 贺鹏程 陈丽梅 习杰英 王孟昌 李静 |
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作者单位: | 西安交通大学医学院第一附属医院血液内科,陕西西安710061 |
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基金项目: | 2010中央高校基本科研业务费专项资金中标项目(编号 xjj20100194) |
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摘 要: | 本研究旨在观察不同动员方法对健康供者外周血造血干细胞的动员效果、采集过程中的不良反应及移植后受者造血功能恢复的影响.2008年1月-2013年5月期间本院43例异基因造血干细胞移植供者分为单纯动员和联合动员两组.单纯动员组采用粒细胞集落刺激因子5-10 μg/(kg·d)皮下注射,动员4-6天开始采集;联合动员组在单纯动员基础上于采集前2-4h给予静脉滴注地塞米松10 mg.观察不同组采集的MNC、CD34+细胞数及其与采集前外周血MNC数的关系,观察采集过程中的不良反应和回输不同组供者造血干细胞后受者造血重建情况.结果表明:两组供者采集造血干细胞数均满足移植需要,单纯动员组采集的MNC及CD34+细胞数均高于联合动员组.两组采集物中MNC与采集前外周血MNC计数均呈正相关;联合动员组采集后血红蛋白及血小板下降幅度较单纯动员组明显.单纯动员组采集过程中不良反应轻微,可以耐受及逆转,联合动员组未出现不良反应.在两组患者预处理方案无统计学差异的情况下,联合动员组相应的受者造血重建时间较单纯动员组明显缩短.结论:在G-CSF动员供体外周血干细胞时加用地塞米松,可以减少外周血造血干细胞采集的不良反应,可采集到足够的造血干细胞数,采集前外周血中MNC计数仍可以作为评估采集物中MNC高低的一项参考指标,特别是联合地塞米松动员干细胞对于受者造血重建有积极意义.
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关 键 词: | 造血干细胞采集 CD34+细胞 造血重建 G-CSF动员 外周血干细胞 地塞米松 |
Effect of Dexamethasone on G-CSF Mobilization of Peripheral Blood Stem Cells in Healthy Donors and Hematopoietic Reconstruction in the Recipients |
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Affiliation: | LIU Hua-Shenga , WANG Xiao-Ning , LIU Hai-Bo ,LIU Xin ,HE Peng-Cheng , Chen Li-Mei, Xi Jie-Ying , WANG Meng-Chang , LI Jin,ZHANG Hai-Tao ,ZHANG Mei* Department of Hematology, The First Affiliated Hospital of Xi ' an Jiao Tong University, Xi ' an 710061, Shaanxi Province, China Co-first authors: LIU Hua-Sheng and WANG Xiao-Ning contributed equally to this work. |
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Abstract: | This study was aimed to investigate the effects of different mobilization methods on mobilization and collection of peripheral blood stem cells in healthy donors and the adverse effect of collection, as well as hematopoietic construction in recipients. A total of 43 donors between January 2008 and May 2013 were divided into the simple mobilization group and the combined mobilization group. The simple group was subcutaneously injected with 5.0 - 10.0 μg/(kg· d) recombinant human granulocyte colony-stimulating factor (rhG-CSF), and the combined mobilization group was treated with rhG-CSF and intravenously dripped with 10 mg dexamethasone for 2 -4 hours before collection. The acquisition and count of MNC and CD34 + cells in different groups, the relationship between the stem cells and MNC count in blood before collection, and the adverse reactions were analyzed; the hematopoietic reconstruction of recipients was investigated. The results showed that the hematopoietic stem cell number of the two groups meet the demands. The count of MNC and CD34 + cells in the simple mobilization group was more than that in the combined mobilization group. The MNC count in two groups positively correlated with peripheral blood MNC count before collection. The decline of hemoglobin and platelet levels was more obvious in the simple mobilization group than that in combined mobilization group. The adverse reactions of collection in the simple mobilization group could be well tolerated and reversed. There was no adverse reaction in the combined mobilization group. The differences of conditioning regimens between two groups were not statistically significant and the hematopoietic reconstruction time of combined group was shorter than that in the simple mobilization group. It is concluded that the adverse reactions in process of collection can be reduced, and enough hematopoietic stem cells can be collected by G-CSF plus dexamethasone in mobilization of peripheral blood stem cells. The count of MNC in peripheral blood before collection can be still used as a reference index to evaluate the acquisition of MNC. Especially the combination with dexamethasone for stem cell mobilization can promote the hematopoietic reconstruction of the recipients. |
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Keywords: | hematopoietic stem cell collection CD34+ cell count hematopoietic reconstruction G-CSF mobilization peripheral blood stem cell dexamethasone |
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