切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 419 -423. doi: 10.3877/cma.j.issn.1674-0785.2019.06.003

所属专题: 文献

临床研究

实体瘤患者与健康供者外周血造血干细胞未动员采集因素分析
纪黎明1, 陆紫敏1,(), 方琦1, 刘承重1, 李雪晨1   
  1. 1. 200065 上海,同济大学附属同济医院输血科
  • 收稿日期:2018-09-03 出版日期:2019-03-15
  • 通信作者: 陆紫敏
  • 基金资助:
    上海市卫生局科研课题资助项目(2010046); 上海市公共卫生重点学科建设计划资助(12GWZX0202)

Factors influencing collection of non-mobilized peripheral blood stem cells from solid tumor patients and healthy donors

Liming Ji1, Zimin Lu1,(), Qi Fang1, Chengzhong Liu1, Xuechen Li1   

  1. 1. Department of Blood Transfusion, Affiliated Tongji Hospital, Shanghai Tongji University, Shanghai 200065, China
  • Received:2018-09-03 Published:2019-03-15
  • Corresponding author: Zimin Lu
  • About author:
    Corresponding author: Lu Zimin, Email:
引用本文:

纪黎明, 陆紫敏, 方琦, 刘承重, 李雪晨. 实体瘤患者与健康供者外周血造血干细胞未动员采集因素分析[J]. 中华临床医师杂志(电子版), 2019, 13(06): 419-423.

Liming Ji, Zimin Lu, Qi Fang, Chengzhong Liu, Xuechen Li. Factors influencing collection of non-mobilized peripheral blood stem cells from solid tumor patients and healthy donors[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(06): 419-423.

目的

研究影响外周血造血干细胞(PBSC)未动员的采集因素。

方法

对同济大学附属同济医院自2016年1月至2018年6月56例实体瘤组患者及53名健康组供者未采用粒细胞集落刺激因子动员(简称未动员)就使用MCS血细胞分离机采集PBSC,比较分析2组采集前白细胞(WBC)计数、红细胞比容(Hct)、血小板(PLT)计数、血红蛋白(Hb)浓度、单个核细胞(MNC)计数及采集效果差异,并分别与部分影响因素进行相关性分析。

结果

所有未动员采集者均成功采集到一定数量的MNC,CD34细胞。(1)健康组采集前Hct、PLT、Hb指标均高于疾病组[(44.81±3.99)% vs (38.38±4.49)%;(230.91±44.63)×109/kg vs(202.88±60.39)×109/kg;(146.09±16.62)g/L vs (129.07±15.54)g/L],差异具有统计学意义(t=7.84、2.74、5.51,P<0.05)。(2)健康组采集物中MNC总数、WBC计数均高于疾病组[(2.81±1.35)×108/kg vs(1.99±1.05)×108/kg;(92.23±29.46)×109/L vs(54.60±23.61)×109/L],CD34、MNC却低于疾病组[(1.17±0.66)% vs(1.65±1.01)%;(53.68±20.19)% vs(65.11±16.45)%],差异均有统计学意义(t=3.54、7.35、2.91、3.24,P<0.05)。(3)健康组采集物CD34细胞及MNC总数均与采集前Hct指标成负相关(r=-0.30915、-0.19624,P=0.00004、0.01119),CD34细胞数与采集血总容量、采集者体质量成负相关(r=-0.04114、-0.15436,P=0.02612、0.03071);(4)疾病组采集物CD34细胞及MNC总数与采集前PLT计数、采集者体质量指数成正相关(r=0.14135、0.19609;r=0.04678、0.14765,P<0.05),CD34细胞数与采集前WBC计数、体质量成正相关(r=0.02028、0.18605,P<0.05)。

结论

所有未动员采集者其PBSC采集效果与采集前WBC和PLT计数、Hct、体质量指数、采集循环血量和成品量均有关联,其中健康组采集物中MNC总数、WBC计数高于疾病组。

Objective

To investigate the factors that affect the collection of non-mobilized peripheral blood stem cells (PBSCs).

Methods

Autologous PBSCs without mobilization with granulocyte colony stimulating factor (G-CSF) were collected from 56 patients with solid tumor and 53 healthy donors at the Affiliated Tongji Hospital of Tongji University from January 2016 to June 2018 using an MCS+ blood cell separator. White blood cells (WBC), hematocrit (Hct), platelets (PLT), hemoglobin (Hb), mononuclear cells (MNC), and collection index before and after collection were compared between the two groups. The correlation between collection effects and some influencing factors was analyzed.

Results

A certain number of MNC and CD34+ cells were successfully collected in both groups. Hct, PLT, and Hb in the healthy group were significantly higher than those in the patient group [(44.81±3.99)% (38.38±4.49)%; (230.91±44.63)×109/kg vs (202.88±60.39)×109/kg; (146.09±16.62)g/L vs (129.07±15.54) g/L; t=7.84, 2.74, 5.51, P<0.05)]. The total number of MNC and WBC in the control group was significantly higher than that in the patient group [(2.81±1.35)×108/kg vs (1.99±1.05)×108/kg; (92.23±29.46)×109/L vs (54.60±23.61)×109/L; t=3.54, 7.35, P<0.05], but the percentages of CD34+ cells and MNC were significantly lower than those in the patient group [(1.17±0.66)% vs (1.65±1.01)%; (53.68±20.19)% vs (65.11±16.45)%; t=2.91, 3.24, P<0.05]. The total number of CD34+ cells and MNC in the healthy group was negatively correlated with the pre-harvest Hct index (r=-0.30915, -0.19624; P=0.00004, 0.01119), and the number of CD34+ cells was negatively correlated with the total volume of blood collected and the body mass of the collected patients (r=-0.04114, -0.15436, P=0.02612, 0.03071). The total number of CD34+ cells and MNC in the patient group was positively correlated with the pre-harvest PLT count and the body mass index (r=0.14135, 0.19609; r=0.04678, 0.14765, P<0.05). The number of CD34+ cells was positively correlated with WBC count and body mass before harvest (r=0.02028, 0.18605, P<0.05).

Conclusion

There is a correlation between the collection of non-mobilized PBSCs and WBC, PLT, Hct, body mass index, product volume, and the amount of blood circulation. The total number of MNC and WBC in healthy controls are significantly higher than those in the patient group.

表1 2组研究对象PBSC采集前血常规指标比较(±s
表2 2组研究对象PBSC采集物指标比较(±s
表3 健康组CD34细胞总数和MNC总数采集数单变量相关因素分析
表4 疾病组采集物CD34细胞总数和MNC总数单变量相关因素分析
1
闰国伟,宋朝阳,刘黄睿, 等. 健康供者对外周血造血干细胞动员及采集效果分析 [J]. 实用医学杂志, 2013, 29(9): 1463-1465.
2
Harris RE, Termuhlen AM, Smith LM, et al. Autologous peripheral blood stem cell transplantation in chidren with refractory or relapsed lymphoma results of Chidren′s Oncology Group study A5962 [J]. Biol Blood Marrow Transplant, 2011, 17(2): 249-258.
3
王晓宁,姚建娜,刘芳, 等. 血细胞分离机不同采集程序对外周血造血干细胞分离效果的影响 [J]. 中国实验血液学杂志, 2016, 24(5): 1529-1532.
4
宋建新,沙玲. 外周血干细胞移植中标本放置时间对CD34细胞及单个核细胞及单个核细胞计数结果的影响 [J]. 国际检验医学杂志, 2014, 21(35): 2987-2988.
5
钱震,钱军,张永宁, 等. 外周血造血干细胞动员和采集13例临床分析 [J]. 现代医学, 2014, 42(8): 853-856.
6
陆华,谭海明,黄姗, 等. 常见血常规指标与外周血造血干细胞采集效率的相关性分析 [J]. 中国输血杂志, 2013, 7(26): 642-644.
7
李清,廖和东,蒋迷, 等. 一种细胞分离机不同转速对外周血造血干细胞采集的影响 [J]. 中国输血杂志, 2017, 2(30): 188-190.
8
白雯,王黎明,周建军, 等. 血细胞分离机采集外周血干细胞的相关影响因素 [J]. 中国输血杂志, 2013, 1(26): 77-78.
9
熊艺颖,刘林,唐晓琼, 等. 48例非霍奇金淋巴瘤患者自体外周造血干细胞动员采集的影响因素分析 [J]. 重庆医学, 2017, 46(24): 3328-3331.
10
孙巍,高敏,谢嵘, 等. 151例淋巴瘤外周血造血干细胞采集影响因素分析 [J]. 中国实验血液学杂志, 2016, 24(2): 416-421.
[1] 徐宏贵, 黎阳, 夏焱, 梁洁云, 黄绍良, 方建培. 应用血细胞分离机大容量白细胞单采术釆集小儿外周血干细胞[J]. 中华妇幼临床医学杂志(电子版), 2008, 04(06): 555-562.
[2] 罗应, 晏婷, 陈津. 靶向B7-H3的CAR-T细胞免疫疗法在实体瘤中的应用研究进展[J]. 中华细胞与干细胞杂志(电子版), 2022, 12(04): 243-249.
[3] 张月梅, 李学英, 张晓燕, 乔佳丽, 杨雪莲, 尹晴雪, 陈娟. 亲缘供者外周血红细胞参数对造血干细胞采集影响的经验分析[J]. 中华细胞与干细胞杂志(电子版), 2022, 12(02): 74-78.
[4] 刘兵, 周美龄, 刘韬. CAR-NK治疗肿瘤的研究与临床进展[J]. 中华细胞与干细胞杂志(电子版), 2018, 08(05): 303-309.
[5] 胡健萍, 齐惠颖, 郭建光, 汪东生, 杨晓慧, 胡爱莲, 王冰松, 林赛柔, 王宁利. 中文版美国国家眼科研究所视功能调查问卷共享电子数据库的构建[J]. 中华眼科医学杂志(电子版), 2018, 08(06): 256-263.
[6] 马斌国. 浅谈利用Excel采集月临床检验质量控制指标[J]. 中华临床实验室管理电子杂志, 2019, 07(03): 180-183.
[7] 张丽敏, 吕虹, 张国军, 康熙雄. 诊断学信息采集的新格局[J]. 中华诊断学电子杂志, 2016, 04(02): 104-106.
阅读次数
全文


摘要