CD34+-selected autologous peripheral blood stem cell transplantation (PBSCT) in patients with poor-risk hematological malignancies and solid tumors. A single-centre experience
CD34+-selected autologous peripheral blood stem cell transplantation (PBSCT) in patients with poor-risk hematological malignancies and solid tumors. A single-centre experience
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CD34-选择性自体外周血干细胞移植（PBSCT）用于低危血液恶性肿瘤和实体瘤患者。
DOI：
10.1038/sj.bmt.1700981
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发表时间：
1997
影响因子：
4.8
通讯作者：
D. Niederwieser
中科院分区：
文献类型：
--
作者：
D. Nachbaur;F. Fink;W. Nussbaumer;A. Gächter;G. Kropshofer;C. Ludescher;D. Niederwieser
1994年7月至1996年12月，对28例低危恶性血液病和实体瘤患者进行了外周血干细胞动员。用Ceprate CS系统免疫阳性选择CD34+细胞。至1996年12月，22例患者已回输中位数3.325(0.078~9.5) × 10~6/kg CD34+细胞。在3例患者中，由于CD34+细胞数量为0.5 × 10~6/kg，未选择的备用PBSC必须与选择的CD34+细胞一起输注。粒细胞集落刺激因子(10μg/kg)从+1天开始，所有患者在中位数12天(范围，10-22天)内移植至白细胞<1.0 × 109/L，中位数天数56((范围，10-180))至血小板>；20.0 × 109/L(即血小板输注独立)。与回输2.0 × 106/kg CD34+细胞的患者相比，接受2.0 × 106/kg纯化CD34+细胞的患者恢复白细胞和血小板的时间明显缩短。造血恢复时间与未分离的 ± PBSCT治疗的18例历史对照组患者相似，只是接受 ×CD34+细胞移植的患者的白细胞植入速度明显加快，而接受CD34+细胞移植的患者的血小板恢复时间明显延迟。接受 10 6/kg纯化细胞的患者接受 × 10 6/kg纯化细胞移植。与历史对照相比，总体存活率有提高的趋势，进展/复发的可能性较低。服药后，我们观察到5例严重机会性感染(3例肺部真菌感染，2例隐孢子虫病)。其中4例患者回输了2.0CD34+ × 106/kgCD34+细胞，这可能表明CD34+选择的PBSCT后免疫重建延迟。
Between July 1994 and December 1996, PBSC were mobilized in 28 patients with poor-risk hematological malignancies and solid tumors. CD34+ cells were positively immunoselected using the Ceprate CS System. By December 1996, 22 patients had been reinfused with a median of 3.325 (0.078–9.5) × 106/kg CD34+ cells. In three patients unselected back-up PBSC had to be transfused along with selected CD34+ cells because of a CD34+ cell number <0.5 × 106/kg. G-CSF (10 μ g/kg) was started on day +1 and all patients engrafted within a median day number of 12 (range, 10–22) until leukocytes >1.0 × 109/l and a median day number of 56 (range, 10–180) until platelets >20.0 × 109/l (ie platelet transfusion independence). Time to leukocyte and platelet recovery was significantly shorter in patients receiving >2.0 × 106/kg purified CD34+ cells as compared to patients reinfused with <2.0 × 106/kg CD34+ cells. The hematopoietic recovery time was similar to that of 18 historical control patients treated with unseparated ABMT ± PBSCT with the exception of a significantly faster leukocyte engraftment in patients receiving >2.0 × 106/kg CD34+ cells and a significantly delayed platelet recovery time in patients receiving <2.0 × 106/kg purified CD34+ cells. There was a trend for a better overall survival and a lower probability of progression/relapse as compared to the historical controls. We observed five episodes of serious opportunistic infections (three pulmonary fungal infections, two cases of cryptosporidiosis) after the take. Four of these patients had been reinfused with <2.0 × 106/kg CD34+ cells probably indicating a delayed immune reconstitution after CD34+-selected PBSCT.