伴海洋性贫血供者外周血造血干细胞采集效果分析

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目的观察海洋性贫血供者外周血造血干细胞(PBSC)采集的效果。方法将2008年1月至2010年1月在中山大学附属第一医院血液内科接受PBSC采集的23例HLA全相合亲缘供者分为对照组(不伴海洋性贫血)15例,观察组(伴海洋性贫血)8例。比较两组供者PBSC动员后、采集前的血常规以及单次采集产品中血常规指标以及单个核细胞(MNC)计数和CD34+细胞计数,并观察两组在PBSC回输后造血重建情况。结果两组供者动员后、采集前的血常规中,WBC平均计数和MNC平均计数,比较差异均无统计学意义(P>0.05);但在单次采集后,观察组RBC计数和HCT分别为(1.19±0.40)×1012/L和(0.084±0.032),明显高于对照组(0.79±0.17)×1012/L和(0.059±0.016)(P<0.05),而WBC计数为(125.2±53.1)×109/L、MNC计数为(3.12±1.72)×108/kg和CD34+细胞平均计数为(1.25±0.69)×106/kg,则分别低于对照组的(220.4±25.1)×109/L、(5.87±1.36)×108/kg和3.52±0.82×106/kg(P<0.05);观察组共行采集术13次、对照组供者各行1次采集。观察组MNC计数及CD34+细胞分别为(5.36±0.80)×108/kg和(2.14±0.32)×106/kg,与对照组比较差异均无统计学意义[(6.31±1.37)×108/kg和(3.79±0.82)×106/kg];PBSC回输后,观察组受者中性粒细胞和血小板的造血重建时间与对照组差异无统计学意义(P>0.05)。结论海洋性贫血供者PBSC动员虽不受影响,但单次采集的PBSC产品中红细胞污染较重、MNC和CD34+细胞收获率降低,但适当增加采集次数后,其PBSC数量仍可达到移植要求,且不影响受者的造血重建。 Objective To observe the effect of peripheral blood hematopoietic stem cells (PBSC) collected from marine anemic donors. Methods From January 2008 to January 2010, 23 cases of HLA matched donor with PBSC collected from Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University from January 2008 to January 2010 were divided into control group (without marine anemia), 15 cases and observation group Marine anemia) in 8 cases. Blood samples were collected from two groups of patients before and after PBSC mobilization. Blood samples were collected for routine blood collection and mononuclear cells (MNC) count and CD34 + cell count, and the hematopoietic reconstitution in both groups was observed. Results After the two groups of patients were mobilized, the average WBC count and the average count of MNC in the blood routine before collection were not significantly different (P> 0.05). However, after single collection, the RBC count and HCT in the observation group (1.19 ± 0.40) × 1012 / L and (0.084 ± 0.032), respectively, which were significantly higher than that of the control group (0.79 ± 0.17) × 1012 / L and (0.059 ± 0.016) (220.4 ± 25.1) × 109 / L, MNC count (53.1) × 109 / L, MNC count (3.12 ± 1.72) × 108 / kg and CD34 + (5.87 ± 1.36) × 108 / kg and 3.52 ± 0.82 × 106 / kg (P <0.05). The observation group received 13 acquisitions in a row and the control group donated 1 acquisition in each row. The MNC count and CD34 + cells in the observation group were (5.36 ± 0.80) × 108 / kg and (2.14 ± 0.32) × 106 / kg respectively, with no significant difference compared with the control group [(6.31 ± 1.37) × 108 / kg and (3.79 ± 0.82) × 106 / kg]. After PBSC transfusion, there was no significant difference in the hematopoietic reconstitution time of neutrophils and platelets between the control group and the control group (P> 0.05). Conclusions Although the mobilization of PBSC in marine anemia donors is not affected, the single cell collection of PBSC products is more contaminated by red blood cells and the yield of MNC and CD34 + cells is decreased. However, the number of PBSCs can still reach the requirement of transplantation after the appropriate number of acquisitions, And does not affect the recipient’s hematopoietic reconstruction.
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