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目的探讨急性白血病患者外周血干细胞动员、采集的效率及影响因素。方法对37例急性白血病患者经化疗+生长因子动员,动员第5~10天,当外周血WBC>5×109/L,CD34+>20个/μl时,使用CS-3000 Plus血细胞分离机(Baxter公司)进行外周血干细胞采集;采集前外周血WBC分类单个核细胞(MNC,包括幼稚细胞、淋巴细胞及单核细胞),计算MNC%×WBC计数>(4~6)×109/L预计需要采集循环血容量。分析不同化疗动员时机、疾病、年龄、性别的动员采集,并对采集前外周血进行白细胞计数、分类以及干细胞采集物进行WBC计数、分类和CD34+检测。结果所有患者均成功动员和采集到了外周血干细胞(MNC>6×108/kg,CD34+>2×106/kg),并成功造血重建。急性髓细胞白血病患者采集所获得的MNC与急性淋巴细胞白血病患者采集获得无明显差异;但急性淋巴细胞白血病患者采集获得CD34+细胞明显较多(P=0.015);动员时机的化疗病程与采集物的CD34+细胞呈负相关,动员时机≤3个疗程与≥6个疗程比较,前者CD34+细胞明显较好,具有统计学差异(P=0.028);外周血MNC数值与采集物MNC及CD34+细胞具有相关性(r=0.600,P=0.00;r=0.510,P=0.001)。结论根据不同的疾病、性别、年龄,采用不同的动员采集方案,一般可以成功采集。外周血MNC数值对采集物中CD34+细胞的总量具有一定预测意义。
Objective To investigate the mobilization and collection efficiency of peripheral blood stem cells in patients with acute leukemia and its influencing factors. Methods Thirty-seven patients with acute leukemia were mobilized by chemotherapy and growth factor and mobilized from day 5 to 10. When peripheral blood WBC> 5 × 109 / L and CD34 +> 20 / μl were mobilized, CS-3000 Plus blood cell separator (MNC), including naive cells, lymphocytes and mononuclear cells (MNC% × WBC count> (4 ~ 6) × 109 / L) were collected before the collection of peripheral blood WBC taxonomic mononuclear cells Collect circulating blood volume. The mobilization and collection of timing, disease, age and sex in different chemotherapy mobilization were analyzed. WBC count, classification and CD34 + count of WBC count, classification and stem cell collection before peripheral blood were collected. Results All patients successfully mobilized and collected peripheral blood stem cells (MNC> 6 × 108 / kg, CD34 +> 2 × 106 / kg) and successfully reconstructed hematopoietic cells. No significant difference was found in the acquisition of MNC and acute lymphoblastic leukemia in patients with acute myeloid leukemia; however, the number of CD34 + cells in patients with acute lymphoblastic leukemia was significantly higher (P = 0.015); the duration of chemotherapy and the CD34 + cells were negatively correlated, the timing of mobilization ≤3 courses and ≥6 courses of treatment, the former CD34 + cells were significantly better with statistical difference (P = 0.028); MNC values in peripheral blood were correlated with MNC and CD34 + cells (r = 0.600, P = 0.00; r = 0.510, P = 0.001). Conclusion According to different diseases, gender, age, using different mobilization acquisition programs, the general can be successfully collected. The value of MNC in peripheral blood has a certain predictive value for the total amount of CD34 + cells collected.