作者：李佩 张国芸 朱苹 吴蓓倩 牛强 谢毅作者单位：复旦大学附属华山医院血液科， 上海 200040 6 J' }7 }: S n, {3 M" j: v
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# r8 T ^ I/ _# N: q( Z 【摘要】 本研究观察低剂量人重组粒细胞集落刺激因子(rhGCSF)对非血缘健康供者的影响，探讨用于中华造血干细胞捐赠者资料库提供的非血缘健康供者外周造血干细胞动员方案。56例非血缘健康供者接受rhGCSF 5 μg/（kg·d)皮下注射，在动员第4、5两天或第5、6两天采集干细胞，观察动员效果及不良反应，检测动员前后血常规指标、CD3 、CD4 、CD8 和CD20 细胞比例；对采集物进行单个核细胞（MNC）和CD34 细胞计数；对所有供者随访至2006年5月31日。结果显示： 在rhGCSF动员过程中出现1级毒副作用(按WHO分级标准):腰背酸痛17.9％(10／56)、焦虑失眠8.9％(5／56)、疲乏4．5％(3／56)等，无需特殊处理，无需终止动员。第4、5两天采集和第5、6两天采集所得的MNC分别是（5.95±1.52）×108/kg和（7.19±2.12）×108/kg； CD34 细胞分别是（3.03±1.09）×106/kg和（7.92±2.50）×106/kg。血红蛋白水平、血小板量、CD3、CD4、CD8、CD20百分比动员前后无变化。结论： 5 μg/（kg·d) rhGCSF用于非血缘健康供者的动员是安全而有效的。 $ M( A2 W- v/ ? r
【关键词】粒细胞集落刺激因子； 外周血； 造血干细胞动员； 非血缘供者 : K. a+ y9 l6 W) r- d Peripheral Blood Stem Cell Mobilization with Low Dose rhGCSF in 56 Unrelated Healthy Donors I; ^7 j; V$ y0 J5 m) }; @# {0 }; G; j% z6 B/ N( G
LI Pei, ZHANG GuoYun, ZHU Pin, WU BeiQian, NIU Qiang, XIE Yi 6 ^1 @0 [: C, m$ r9 |4 I 7 v+ k# Z! p" L; s5 }1 cDepartment of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China- l2 l- g: s; i4 V7 l
_. s5 [* d5 ]9 P1 Z2 fAbstractThe study was aimed to observe the effect of recombinant human granulocytecolony stimulating factors (rhGCSF) in low dose on peripheral blood stem cell (PBSC) mobilization in unrelated healthy normal donors. GCSF was administered at 5 μg/（kg·d)subcutaneously for successive 5 or 6 days to 56 unrelated donors. Stem cells were harvested on the fourthand fifth days or on the fifthand sixth days.The numbers of mononuclear cells (MNC), CD34 cells and Hb, Plt, andCD3 , CD4 , CD8 and CD20 cells were determined during the mobilization. The results showed that most common adverse events were bone pain (17.9%,10/56)， agrypnia (8.9%,5/56) and lassitude (4.5%,3/56) during rhGCSF mobilization， but all donors were suffeved less than grade 2 according to the WHO criteria, and did notneedto stop the mobilization and not neeed to give speeial treantment. In harvest on day 4-5 and 5-6, MNC count was (5.95±1.52)108/kg and (7.19±2.12)108/kg； CD34 cellscount was (3.03±1.09)106/kg and (7.92±2.50)106/kg.There were no significant differences in hemoglobin level and platelet count,the percentage of CD3 cells, CD4 cells,CD8 cells cells and CD20 cells between preand postmobilization of rhGCSF.It is concluded that the low dose of rhGCSF5μg/（kg·d)forperipheral blood stem cell mobilization in unrelated healthy normol donors is safe and effective.8 e+ g5 m6 t( I9 C1 ?5 R0 O: x- d
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Key Wordsgranulocytecolony stimulating factor； peripheral bloodhematopoietic stem cellmobilization;unrelated donor $ J- G$ T, l0 H8 ]5 B I- ~1 y2 [2 F+ W" F: L
J Exp Hematol 2007; 15(2):- \- [0 h5 |8 K" e) i0 p8 \
* A# n% P9 K. r5 F异基因造血干细胞移植是治疗血液系统恶性疾病和一些遗传性疾病的有效方法，国际骨髓移植登记组（IBMTR）的统计资料显示，全球范围每年约开展15 000例异基因造血干细胞移植，其中30%为非血缘供者的异基因移植［1］。我国实行独生子女政策，HLA配型相合的同胞供者日益减少，临床上对非血缘健康志愿供者的的造血干细胞（HSC）需求日益增加。正常人外周血干细胞（PBSC）的含量很低，必须通过粒系集落刺激因子动员，才能采集到移植所需的PBSC量。因此，造血干细胞动员和采集技术是AlloPBSCT成功的关键技术之一。 我们从1996年完成国内首例非血缘外周血干细胞移植起，已经为中华造血干细胞捐赠者资料库完成非血缘健康供者外周造血干细胞动员采集56例，现将资料分析总结如下。7 H, w: \- O( _9 `( ` W* W' J/ h