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目的探讨急性白血病异基因外周血造血干细胞移植血缘供者近期的不良事件及远期的安全性。方法 185例急性白血病异基因外周血造血干细胞移植血缘供者,干细胞动员后,用COBE Spectra血细胞分离机采集外周血干细胞。检测供者动员时血常规及形态学分类、CD34+细胞百分比、干细胞混悬液中单个核细胞(MNC)数量及CD34+细胞计数,同时记录供者动员和采集过程中的不良事件、采集后第1、3、7天血常规变化及长期随访。结果血缘供者干细胞动员前白细胞计数为(6.16±1.58)×109·L-1,采集时白细胞计数为(41.55±9.77)×109·L-1,是动员前6.75(4.18~10.87)倍。干细胞混悬液MNC为(247.61±105.99)×108,CD34+细胞为(3.54±3.42)×108。动员时血缘供者的常见不良事件有头痛、腰背困痛、四肢痛、全身痛,合计占94.6%;外周血干细胞采集过程中,静脉持续输注葡萄糖酸钙,供者口周和指尖麻木等低钙症状发生率为3.2%;所有供者的不良事件均可耐受,无一例供者因不良事件终止干细胞动员或采集。供者干细胞采集后1周血象基本恢复正常;随访11 a血缘供者健康状况良好,无与动员及采集相关的远期并发症发生。结论急性白血病异基因外周血造血干细胞移植血缘供者动员采集无明显的近期不良事件及远期并发症,安全性非常高,为非血缘移植供者提供可靠的安全保障依据,减少恐惧感,降低反悔率。
Objective To investigate the recent adverse events and long-term safety of blood donor of allogeneic peripheral blood stem cell transplantation for acute leukemia. Methods 185 cases of acute leukemia allogeneic peripheral blood stem cell transplantation donor, after mobilization of stem cells, peripheral blood stem cells were collected using a COBE Spectra blood cell separator. The blood routine and morphological classification, the percentage of CD34 + cells, the number of mononuclear cells (MNCs) in stem cell suspension and the number of CD34 + cells during the donor mobilization were recorded. At the same time, the adverse events during donor mobilization and collection were recorded. , 3,7 days of blood changes and long-term follow-up. Results The number of white blood cells of blood donor stem cells before mobilization was (6.16 ± 1.58) × 109 · L-1. The number of white blood cells collected at the time of acquisition was (41.55 ± 9.77) × 109 · L-1, which was 6.75 (4.18-10.87) times before mobilization. MNC of stem cell suspension was (247.61 ± 105.99) × 108, and that of CD34 + cells was (3.54 ± 3.42) × 108. A total of 94.6% of the common adverse events of blood donors during blood mobilization were headache, back pain, limb pain and whole body pain. During the process of peripheral blood stem cell collection, intravenous infusion of calcium gluconate, perioral and fingertips The incidence of hypocalcemia such as numbness was 3.2%. All donors were able to tolerate adverse events. None of the donors stopped mobilizing or collecting stem cells due to adverse events. One week after donor stem cells collection, the blood picture returned to normal. The 11-day follow-up of blood donors was in good health with no long-term complications related to mobilization and acquisition. Conclusion Acute leukemia allogeneic peripheral blood hematopoietic stem cell transplantation blood donor mobilization without obvious immediate adverse events and long-term complications, the safety is very high, provide a reliable basis for the safety of non-blood transplant recipients to reduce the fear and reduce Rift rate.