Transplantation of highly purified CD34+Thy-1+ hematopoietic stem cells in patients with recurrent indolent non-Hodgkin's lymphoma.
Transplantation of highly purified CD34+Thy-1+ hematopoietic stem cells in patients with recurrent indolent non-Hodgkin's lymphoma.
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对复发性惰性非霍奇金淋巴瘤患者进行高度纯化的 CD34 Thy-1 造血干细胞移植。
DOI：
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发表时间：
2001
影响因子：
4.3
通讯作者：
J. Armitage
中科院分区：
文献类型：
--
作者：
J. Vose;P. Bierman;J. Lynch;K. Atkinson;C. Juttner;E. Hanania;G. Bociek;J. Armitage
目的
评估高剂量化疗和高度纯化的“动员的”外周血 CD34+Thy-1+ 造血干细胞 (HSC) 移植对复发性惰性非霍奇金淋巴瘤 (NHL) 或套细胞淋巴瘤 (MCL) 患者的结果。
患者和方法
26 名复发性惰性 NHL 或 MCL 患者单独使用粒细胞集落刺激因子 (G-CSF) 或环磷酰胺联合 G-CSF 进行动员。进行单采，最初使用Isolex免疫磁性阳性CD34+细胞选择装置纯化产物，随后进行高速流式细胞术细胞分选，最终纯化CD34+Thy-1+ HSC。患者接受高剂量 BEAC（卡莫司汀、依托泊苷、阿糖胞苷和环磷酰胺）化疗，然后在 2 个剂量组中移植纯化的 HSC（组 1：> 或 = 5 x 10(5) 活的纯 HSC/kg；组 2：> 或 = 3 x 10(5) HSC/kg）。
结果
我们试图动员 26 名仅患有 G-CSF 的患者。六名患者单独使用 G-CSF 未能收集到足够的细胞；随后尝试用环磷酰胺加 G-CSF 动员，但这 6 名患者未能收集到足够的 CD34+Thy-1+ HSC。 20 名患者接受了 BEAC 移植方案的移植，随后进行了纯化的 HSC。第 1 组中的患者在中位第 12 天移植至中性粒细胞绝对计数 (ANC) >500/μL，中位第 19 天实现血小板输注独立，中位第 20 天实现红细胞输注独立。第 2 组中的患者在中位第 12 天移植至 ANC >500/μL，中位第 12 天实现血小板输注独立，中位第 12 天实现红细胞输注独立。 20 名患者中有 14 名在移植后的某个时间点报告有严重感染，包括流感、呼吸道合胞病毒、肺炎和卡氏肺孢子虫肺炎。中位随访时间为 38 个月，20 名患者中有 8 名患有进行性淋巴瘤，5 名患者死亡。 3 年无事件生存率为 55%，总生存率为 78%。
结论
CD34+Thy-1+ HSCs 可以从大多数仅用 G-CSF 动员的淋巴瘤患者中成功收集。在这项使用这些细胞的小型试点研究中，患者的植入和疾病结果似乎与文献中引用的类似患者的结果没有不同。然而，感染的短期和长期风险是该患者群体的一个担忧。
PURPOSE
To evaluate the results of high-dose chemotherapy and transplantation of highly purified "mobilized" peripheral blood CD34+Thy-1+ hematopoietic stem cells (HSCs) in patients with recurrent indolent non-Hodgkin's lymphoma (NHL) or mantle cell lymphoma (MCL).
PATIENTS AND METHODS
Twenty-six patients with recurrent indolent NHL or MCL were mobilized witheither granulocyte colony-stimulating factor (G-CSF) alone or cyclophosphamide plus G-CSF. Apheresis was performed, and the product was purified using the Isolex immunomagnetic positive CD34+ cell selection device initially and subsequent high-speed flow-cytometric cell sorting for the final purification of CD34+Thy-1+ HSCs. The patients received high-dose chemotherapy with BEAC (carmustine, etoposide, cytarabine, and cyclophosphamide) followed by transplantation with the purified HSCs in 2 dose cohorts (cohort 1: > or =5 x 10(5) viable and pure HSC/kg; cohort 2: > or =3 x 10(5) HSC/kg).
RESULTS
We attempted to mobilize 26 patients with G-CSF alone. Six patients did not collect adequate cells with G-CSF alone; subsequent mobilization with cyclophosphamide plus G-CSF was attempted, but adequate CD34+Thy-1+ HSCs could not be collected on these 6 patients. Twenty patients underwent transplantation with the BEAC transplantation regimen followed by purified HSCs. Patients in cohort 1 engrafted at a median of day 12 to an absolute neutrophil count (ANC) >500/microL, a median of day 19 for platelet transfusion independence, and a median of day 20 for red blood cell transfusion independence. Patients in cohort 2 engrafted at a median of day 12 to an ANC >500/microL, a median of day 12 for platelet transfusion independence, and a median of day 12 for red blood cell transfusion independence. Fourteen of the 20 patients had significant infections reported at some point posttransplantation, including influenza, respiratory syncytial virus, pneumonitis, and Pneumocystis carinii pneumonia. With a median follow-up of 38 months, 8 of the 20 patients have had progressive lymphoma and 5 patients have died. The 3-year event-free survival is 55%, and overall survival is 78%.
CONCLUSIONS
CD34+Thy-1+ HSCs can be collected successfully from most lymphoma patients mobilized with G-CSF alone. The engraftment and disease outcomes in the patients in this small pilot study using these cells do not appear to be different from the outcomes of similar patients cited in the literature. However, the short- and long-term risks of infection were a concern in this patient population.
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影响因子：
20.3
作者：
Lesley J. Murray;B. Chen;A. Galy;S. Chen;R. Tushinski;N. Uchida;R. Negrin;G. Tricot;S. Jagannath;D. Vesole
通讯作者：
Lesley J. Murray;B. Chen;A. Galy;S. Chen;R. Tushinski;N. Uchida;R. Negrin;G. Tricot;S. Jagannath;D. Vesole
尽管自体外周血干细胞移植的非霍奇金淋巴瘤患者的免疫调节细胞因子基因表达水平较高，但免疫功能障碍。
影响因子：
2.6
作者：
Singh,RK;Varney,ML;Ino,K;Vose,JM;Bierman,PJ;Talmadge,JE
通讯作者：
Talmadge,JE
DOI：
10.1002/jca.2920100307
发表时间：
1995
期刊：
Journal of clinical apheresis.
影响因子：
--
作者：
Anderson,KC
通讯作者：
Anderson,KC
影响因子：
20.3
作者：
Glaspy, JA;Shpall, EJ;McNiece, IK
通讯作者：
McNiece, IK