摘要
背景:异基因外周血造血干细胞移植大约1/3是在ABO血型不合的供受者之间进行的。目的:探讨ABO血型主要不合供者外周血造血干细胞在不去除红细胞情况下应用COM.TEC血细胞分离机直接回输给受者的可行性。方法:27例HLA全相合同胞供者皮下注射粒细胞集落刺激因子5μg/(kg?d),连续5d干细胞动员,于第5天开始应用COM.TEC血细胞分离机进行外周血造血干细胞单采,每次总处理血量为3.0～3.5个供者全身血量。ABO相合供者按常规方法进行单采,主要不合供者采取动态调整白膜收集量和保持稳定充足的血流量以减少红细胞污染。结果与结论:27例供者中ABO主要不合供者11例,相合供者16例。主要不合组产品体积及红细胞内含量均显著低于相合组(P<0.05),回输给受者均未出现急性溶血反应;2组单个核细胞及CD34+细胞计数差异无显著性意义(P>0.05),受者均获造血重建,中性粒细胞及血小板重建时间相似(P>0.05)。提示应用COM.TEC血细胞分离机进行ABO主要不合供者外周血造血干细胞单采,可以保持稳定充足的血流量情况下通过动态调整白膜收集量参数,在不影响采集产品产量和质量的同时显著减少红细胞的污染,预防回输后受者的急性溶血反应。
BACKGROUND：Approximately 1/3 allogeneic peripheral blood stem cells（PBSCs） transplantation treatments are performed between ABO mismatched donors-recipients pairs.OBJECTIVE：To evaluate the feasibility of PBSCs collection in major ABO mismatched donors with COM.TEC blood cell separator and infusion to the recipients without removal of erythrocytes from the PBSCs graft.METHODS：Twenty-seven HLA-identical sibling donors received priming with granulocyte colony stimulating factor（G-CSF） 5 μg/kg/d via subcutaneous injection for 5 days.PBSCs collection started on day 5 using COM.TEC blood cell separator.The procedure processed 3.0-3.5 times of the total blood volume（TBV）.For major ABO mismatched donors,specialized harvesting strategies of adjusting the volume of buffy coat and maintaining adequate and stable flow rate during apheresis were to diminish red blood cells（RBCs） contents of PBSCs.RESULTS AND CONCLUSION：Of the 27 donors,there were 11 major ABO-incompatible and 16 ABO-identical.The volumes of PBSCs graft and RBCs harvested in major ABO-incompatible group were significantly lower than those of ABO-identical group（P〈0.05）.The number of mononuclear cells and CD34＋ cells per recipient body weight did not statistically differ between the two groups（P〈0.05）.All recipients reconstituted hematopoiesis following allo-PBSCT.Mean time to neutrophil and platelet engraftment was no significant difference between ABO-identical and major incompatible transplantaions（P〈0.05）.PBSC harvesting from major ABO mismatched donors can be successfully performed with COM.TEC blood cell separator.Adjustment the volume of buffy coat and maintenance of adequate and stable flow rate during procedure can reduce RBC contamination for prevention of immune hemolysis;meanwhile collecting a sufficient number of CD34＋ cells to ensure prompt engraftment post-transplantation.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2011年第36期6781-6784,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
作者简介
王荷花，女，1972年生，江西省南昌市人，汉族，2004年中国协和医科大学毕业，博士，主治医师，主要从事造血干细胞移植的研究。md．vicky@gmail．com
