摘要
目的探讨严重自身免疫性疾病患者外周血CD34+细胞动员的规律和安全性。方法以CTX+rhG-CSF方案对严重自身免疫性疾病患者进行外周血CD34+细胞动员。结果动员后可获得单个核细胞(MNC)4.52(1.15~14.05)×108/kg,其中CD34+细胞为5.18(1.30~26.35)×106/kg。19例次患者注射CTX后ANC<0.5×109L-1,获得MNC 4.33(1.15~9.5)×108/kg、CD34+细胞5.16(1.30~26.35)×106/kg;23例次患者注射CTX后ANC≥0.5×109L-1,获得MNC 4.45(1.21~14.05)×108/kg、CD34+细胞5.41(1.0~24.10)×106/Kg。2组间无差异。动员过程中原发病无明显恶化,所有患者原发病均得到不同程度的缓解。其中SLE患者SLE-DAI评分由17(12~24)分降至3(0~4)分(P<0.01),RA患者均达到ACR20标准。1例患者出现急性肾功能衰竭,1例患者死于TTP,3例患者动员失败。结论以CTX+rhG-CSF方案可有效地动员出足够的CD34+细胞,并能缓解原发病。动员过程中不良反应可耐受,但仍发生严重并发症甚至死亡。在少数动员失败的患者中,原因尚需进一步探讨。
Objective To evaluate the feasibility and safety of peripheral CD34^＋ cell mobilization in the patients with severe autoimmune disease. Methods The patients were mobilized by the regimen of cyclophosphamide ＋ rhG-CSF. Results After mobilization, the MNC and CD34^＋ cells were gained by a median of 4.52（ 1.15 - 14.05 ）× 10^8/kg and 5.18（1.30 - 26.35） ×10^6/kg respectively. There were 19 case times among which the patients＇ ANC 〈 （0.5× 10^9/L, and 23 times of patients＇ ANC≥0.5 ×10^9/L. Comparing these two groups of patients, the MNC yields were a mean of 4.33 （ 1.15- 9.5 ）×10^8/kg and 4.45 （ 1.21 - 14.05 ）× 10^8/kg respectively ; and the CD34^＋ cells yields were a median of 5.16（ 1.30 - 26.35）× 10^6/kg and 5.41 （ 1.0 - 24.10）× 10^6/kg respectively. The underlying diseases were not exacerbated but ameliorated more or less by mobilization. In SLE group, SLE-DAI score decreased from mean of 17（ 12 - 24） points to 3（0 - 4） points （P 〈 0.01 ）. For RA patients, an ACR20 response was achieved in all five patients. One pa- tient suffered acute renal failure, one died of thrombotic thrombocytopenic purpura （TTP）. Failed mobilization occurred in three patients. Conclusion Sufficient CD34^＋ cells could be mobilized by the low dose of cyclophosphamide and rhGCSF. It not only appropriated in effectiveness and safety but also ameliorate the disease.
出处
《基础医学与临床》
CSCD
北大核心
2006年第4期405-408,共4页
Basic and Clinical Medicine
关键词
自身免疫性疾病
造血干细胞动员
autoimmune disease
heamatopoietie stem cell mobilization
