影响自体外周血造血干细胞采集数量、质量的相关因素研究(1)
【摘要】 目的 阐明自体外周血造血干细胞采集患者术前各相关因素对采集的造血干细胞数量、质量的影响及程度，建立自体外周血造血干细胞采集前患者合理准备方案。方法 入选我院2013年2月至2014年1月恶性血液病患者12例，进行生长因子与化疗联合方案动员后，应用费森尤斯COM.TEC血细胞分离机采集自体外周血造血干细胞，分析影响其采集数量、质量的相关因素。结果 12例病人共采集自体外周血造血干细胞31次，其中动员1次病人10例(3例病人采集3次，7例病人采集2次)；动员2次病人1例，第1次动员采集2次，第2次动员采集1次；动员3次病人1例，前两次动员各采集2次，第3次动员采集1次，共采集5次；采集成功者7例，采集失败者5例，采集成功组与采集失败组的MNC值、CD34+细胞数有统计学意义(P<0.05)；同一病人连续进行造血干细胞采集时，第二天的造血干细胞中CD34+、MNC细胞水平显著高于第一天水平，差异有统计学意义(P<0.05)。结论 采集自体外周血造血干细胞受患者基础疾病、并发症、血管条件、采集时间、动员效果、饮食、运动及心理状态等因素影响，对相关因素进行干预，可以提高外周血造血干细胞采集的数量和质量，提高疗效，降低相关并发症。
【关键词】 相关因素；采集；自体外周血造血干细胞
【Abstract】Objective To illustrate the factors which influence the quantity and quality of autologous peripheral blood hematopoietic stem cells collection， and to establish reasonable scheme before hematopoietic stem cells collection. Methods The study enrolled 12 patients with hematologic malignancy in our ward from February 2013 to January 2014. After mobilization using growth factors and chemotherapy， the Fresenius COM.TEC was used to collect autologous peripheral blood hematopoietic stem cells. Results 31 hematopoietic stem cells collections occurred in 12 patients. 10 cases mobilized 1 time (3 patients collected 3 times， 7 patients collected twice)； 1 case mobilized two times ， first mobilization collect 2 times， second mobilization collect 1 time； 1 case mobilized three times ， the previous two mobilizing collected 2 times respectively， the following third time mobilization collected 1 times； Successful collection occurred in 7 cases， and failed in 5 cases. Significant difference were observed in MNC value and CD34+ cells between success group and failure group (P < 0.05). For consecutively hematopoietic stem cells collections， CD34 + cells and MNC in second collection significantly higher than that in first collection (P < 0.05). Conclusion The collection of autologous peripheral blood hematopoietic stem cells was affected by patients’ basic diseases， complications， patients’ vascular conditions， acquisition time， the effects of mobilization， diet， physical exercise and psychological state. To interfere the related factors can improve the quality and quantity of peripheral blood hematopoietic stem cells collection， improve curative effect， and reduce the related complications.
【key words 】related factors； collection； autologous peripheral blood hematopoietic stem cells；
【中图分类号】R722.12 【文献标识码】B【文章编号】1004-4949(2015)02-0034-01
近年来，外周血造血干细胞移植已成为血液系统恶性病变的根治方法之一，异基因造血干细胞移植具有风险较高、配型难度较大、医疗成本较高等因素，临床应用受到一定限制[1]。相对而言自体外周血造血干细胞移植具有无需免疫抑制，造血功能及免疫功能恢复迅速，移植相关并发症较少、死亡率较低等优越性。对于无人类白细胞抗原配型相合供者或不具备异基因造血干细胞移植条件的患者，可予以移植自体外周血造血干细胞，延长患者的生存期，提升患者的生命质量[2]。自体外周血造血干细胞移植是否成功，很大程度取决于造血干细胞的数量及质量[3]。探析影响自体外周血干细胞采集数量、质量的相关因素具有重要的临床价值，故对我院2013年2月至2014年1月12例恶性血液病患者进行生长因子与化疗联合方案动员后，应用血细胞分离机采集自体外周血造血干细胞，分析影响其采集数量、质量的相关因素，现报道如下。, 百拇医药(江雪梅 马海霞 吴霞)
【关键词】 相关因素；采集；自体外周血造血干细胞
【Abstract】Objective To illustrate the factors which influence the quantity and quality of autologous peripheral blood hematopoietic stem cells collection， and to establish reasonable scheme before hematopoietic stem cells collection. Methods The study enrolled 12 patients with hematologic malignancy in our ward from February 2013 to January 2014. After mobilization using growth factors and chemotherapy， the Fresenius COM.TEC was used to collect autologous peripheral blood hematopoietic stem cells. Results 31 hematopoietic stem cells collections occurred in 12 patients. 10 cases mobilized 1 time (3 patients collected 3 times， 7 patients collected twice)； 1 case mobilized two times ， first mobilization collect 2 times， second mobilization collect 1 time； 1 case mobilized three times ， the previous two mobilizing collected 2 times respectively， the following third time mobilization collected 1 times； Successful collection occurred in 7 cases， and failed in 5 cases. Significant difference were observed in MNC value and CD34+ cells between success group and failure group (P < 0.05). For consecutively hematopoietic stem cells collections， CD34 + cells and MNC in second collection significantly higher than that in first collection (P < 0.05). Conclusion The collection of autologous peripheral blood hematopoietic stem cells was affected by patients’ basic diseases， complications， patients’ vascular conditions， acquisition time， the effects of mobilization， diet， physical exercise and psychological state. To interfere the related factors can improve the quality and quantity of peripheral blood hematopoietic stem cells collection， improve curative effect， and reduce the related complications.
【key words 】related factors； collection； autologous peripheral blood hematopoietic stem cells；
【中图分类号】R722.12 【文献标识码】B【文章编号】1004-4949(2015)02-0034-01
近年来，外周血造血干细胞移植已成为血液系统恶性病变的根治方法之一，异基因造血干细胞移植具有风险较高、配型难度较大、医疗成本较高等因素，临床应用受到一定限制[1]。相对而言自体外周血造血干细胞移植具有无需免疫抑制，造血功能及免疫功能恢复迅速，移植相关并发症较少、死亡率较低等优越性。对于无人类白细胞抗原配型相合供者或不具备异基因造血干细胞移植条件的患者，可予以移植自体外周血造血干细胞，延长患者的生存期，提升患者的生命质量[2]。自体外周血造血干细胞移植是否成功，很大程度取决于造血干细胞的数量及质量[3]。探析影响自体外周血干细胞采集数量、质量的相关因素具有重要的临床价值，故对我院2013年2月至2014年1月12例恶性血液病患者进行生长因子与化疗联合方案动员后，应用血细胞分离机采集自体外周血造血干细胞，分析影响其采集数量、质量的相关因素，现报道如下。, 百拇医药(江雪梅 马海霞 吴霞)