摘要
目的:探讨淋巴瘤患者自体外周血造血干细胞动员采集过程中的影响因素。方法:收集2009年4月至2021年4月于联勤保障部队第九四〇医院血液科行自体外周血干细胞采集的74例淋巴瘤患者的临床资料,分析性别、年龄、疾病类型、分期、病程、化疗周期、复发、放疗、疾病状态、采集当天血常规指标等因素对外周血造血干细胞采集结果的影响。结果:71例(95.9%)患者外周血干细胞采集成功,采集优良53例(71.6%);化疗周期≤6与> 6个的患者采集移植物中CD34^(+)细胞数比较有显著性统计学差异[(9.1±5.2)×106/kgvs (6.4±3.7)×10~6/kg,P=0.031];首次采集物中CD34^(+)细胞数与采集当天白细胞数、血红蛋白、血小板数、中性粒细胞数、淋巴细胞数、单核细胞数、红细胞比容均呈正相关(r值分别为0.424、0.486、0.306、0.289、0.353、0.428、0.528),其中白细胞数、血红蛋白、单核细胞数、红细胞比容这4种指标对首次CD34^(+)细胞采集效果的预测价值较高(ROC曲线下面积分别为0.7061、0.7845、0.7319、0.7848)。结论:较小剂量环磷酰胺、依托泊苷化疗联合重组人粒细胞集落刺激因子可以有效动员自体外周血干细胞;采集前化疗周期≤6的患者自体外周血干细胞动员采集效果好;血常规指标对首次采集效果有预测价值。
Objective:To analyze the factors influencing collection of autologous peripheral blood hematopoietic stem cells in lymphoma patients.Methods:Clinical data of 74 patients who received autologous peripheral blood hematopoietic stem cells mobilization and collection in the 940th Hospital of Joint Logistic Support Force of PLA from April2009to April2021were collected.The effects of gender,age,disease type,stage,course of disease,chemotherapy cycle number,relapse,radiotherapy,disease status and blood routine indexes on the day of collection on peripheral blood hematopoietic stem cell collection were analyzed.Results:The success rate of collection was 95.9%(71/74),and the excellent rate of collection was71.6%(53/74).There was a significantly statistical differentce in the number of CD34~+ cells in grafts collected from patients with chemotherapy cycle≤6 and 6 [(9.1 ± 5.2) × 10~6/kg vs(6.4 ± 3.7) × 10~6/kg,P= 0.031].The number of CD34~+ cells in the first collection was positively correlated with WBC count,hemoglobin,platelet count,neutrophil count,lymphocyte count,monocyte count and hematocrit value on the day of collection(r value was 0.424,0.486,0.306,0.289,0.353,0.428,0.528,respectively).WBC count,hemoglobin,monocyte count and hematocrit value have higher predictive value for the first collection of CD34~+ cells.The area under the receiver operating characteristic was 0.7061,0.7845,0.7319,0.7848,respectively.Conclusion:Low dose CTX and VP16 chemotherapy combined with G-CSF can effectively mobilize autologous peripheral blood stem cells.The cycle number of chemotherapy relates to the collection of autologous peripheral blood stem cells.After mobilization,the success of the first collection can be better predicted by the blood routine indexes.
作者
刘恒
葸瑞
白海
吴涛
Heng;XI Rui;BAI Hai;WU Tao(Department of Hematology,the 940th Hospital of Joint Logistic Support Force of PLA,Lanzhou 730050,Gansu Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2023年第6期1845-1851,共7页
Journal of Experimental Hematology
基金
甘肃省创新基地和人才计划(甘肃省白血病临床医学研究中心)(21JR7RA015)。
