Establishment of new hematopoietic stem cell transplantation strategy with purified blood CD34+ cells

本研究的目的是建立一种新的治疗策略，用于治疗各种类型的疾病，这些疾病可以在自体和同种异体环境中使用纯化的血液CD 34+细胞进行造血干细胞移植治疗。在自体环境中，不需要的细胞如淋巴细胞或肿瘤细胞应通过纯化程序去除。另一方面，在同种异体环境中，纯化的主要目的将是在来自HLA不匹配供体的移植的情况下有效预防移植物抗宿主病。本研究分三个阶段进行：1）建立动员和收获程序; 2）血液纯化CD 34+细胞移植作为一种新策略的临床应用; 3）评估移植后长期造血和免疫的恢复和维持。 ...更多信息 儿童和成人捐赠者之间的差异然后，我们得出结论，儿童可以成为更适合的PBSC捐赠者，因为G-CSF注射的不良事件较少，动员和收获程序更有效。在接下来的一年里，我们成功地治疗了一名患有慢性炎症性关节炎的患者，该患者严重依赖皮质类固醇，导致身材矮小并患有心理问题。在这种自体移植中，我们证实了高剂量环磷酰胺和抗淋巴细胞球蛋白随后纯化的血液CD 34+细胞的免疫抑制治疗是有效的，并持续了两年。从患者和供体的角度来看，移植细胞的功能也是令人满意的，从数据中，我们得出结论，纯化的血液CD 34+细胞的一部分是一个有用的干细胞来源，在自体和异体移植设置。这种类型的移植应该扩展到细胞治疗的新领域。少

The purpose of this study was the establishment for a new therapeutic strategy in the treatment of various types of disease that could be treated with hematopoietic stem cell transplantation using purified blood CD34+ cells in both autologous and allogeneic settings. In autologous setting, unwanted cells such as lymphocytes or tumor cells should be depleted by the purification procedure. On the other hand, in allogeneic setting, the main purpose of purification will be an effective prophylaxis against graft-versus-host disease in the case of transplantation from HLA mismatched donors. During the study period, the projects were divided into three steps ; 1) establishment of mobilization and harvesting procedures, 2) clinical application of blood purified CD34+ cell transplantation as a new strategy, and 3) evaluation for long-term hematopoietic and immune recovery and maintenance after transplantation.In the first year, we compared the mobilization and harvesting efficacy of blood CD34+ … More cells between pediatric and adult donors. Then, we concluded that children could become more suitable donors for PBSC donation, because of less frequent adverse events by G-CSF injection, and more effectiveness in mobilization and harvesting procedures. In the next year, we successfully treated a patient with chronic inflammatory arthritis who was heavily depended on corticosteroids resulting in a short stature and suffering psychological problems. In this auto grafting, we confirmed that an immune suppressive therapy by high-dose cyclophosphamide and anti-lymphocyte globulin followed by purified blood CD34+ cells was effective and it continued over tow years. The function of the graft cells was also satisfactory from the aspects of both patients and donors.From the data, we concluded that a fraction of purified blood CD34+ cells was a useful stem cell source for transplantation in both autologous and allogeneic settings. This type of transplantation should be expanded into the new field of cell therapy. Less