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BACKGROUND: Effective mobilization and collection of hemopoietic stem cells are initial factors for peripheral stem cell transplantation, while they make sure a permanent reconstruction of hemopoiesis. Mobilization and collection have been developed; however, the collection is more, and the yield of hemopoietic stem cells is various. OBJECTIVE: To investigate the best time of mobilization and collection of peripheral blood stem cells from healthy donors. METHODS: A total of 16 donors who were selected from Haikou People's Hospital between January 2003 and December 2008 were randomly divided mobilization group (A, n=6) and mobilization + collection group (B, n=10). A group was subcutaneously injected with 5.0-10.0 μg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF) (Filgrastim), and B group was treated with rhG-CSF and intravenously injected with 10 mg dexamethasone. Peripheral stem cells were collected twice in each group. The two groups were collected at the fourth and 5~(th) day of mobilization after the second or 4th hour subcutaneous injection of rhG-CSF. The collection was 4.0-5.0 mL, the manhandled volume was 3.0-5.0 mL, and the total blood volume was 6.7-10.1 L. RESULTS AND CONCLUSION: Number of mononuclear cells was (4.0-8.0)×10~8 kg~(-1) in the two groups. The cell concentration of fourth hour was higher than the second hour after rhG-CSF treatment (P < 0.05). The mononuclear cell concentration of fourth hour was higher than the second hour after the fourth and 5~(th) day of rhG-CSF treatment. Our research showed that we could collect sufficient amount of cells (to a high concentration) by one time, which had reasonable collection time - value-effectiveness relationship, when the cycle blood volume was 1.8-2.2 times of circulating blood volume.
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BACKGROUND:In allogene hematopoietic stem cell transplantation,the choice of preconditioning scheme is an important link of the success of hematopoietic stem cell transplantation,and a major research direction of stem cell transplantation.The myeloablative pretreatment scheme has great toxicity,and pretreatment related death rate is high.Thus,it is necessary to explore an ideal pretreatment scheme to expect a decrease in side effects and relapse.OBJECTIVE:To observe the effect of modified Bu/CY pretreatment regimen for treating hematologic malignancies.METHODS:The 8 patients were selected at the Department of Hematology,Haikou Municipal People's Hospital Affiliated to Xiangya School of Medicine,Central South University from November 2003 to March 2008,and received modified Bu/CY pretreatment:cytarabine 2.0-3.0 g/(m2·d)×2 d,intravenous drip,for 24 consecutive hours;myleran 4 mg/(kg·d)×3 d;cyclophosphamide 50 mg/(kg·d)×2 d;methyl-cyclohexyl nitrosourea 25 mg/(m2·d)×1 d;antithymocyte globulin 25 mg/(kg·d)×4 d. We have increased the arabinosylcytosin dose twice,and changed to a 24-hour infusion via intravenous drip,so that pretreatment strength was increased and promote lasting implantation of hematopoietic stem cells,based on the modified program.Graft-versus-host disease(GVHD)prevention:cyclosporin A and mycophenolate mofetil would be used advanced to minus 7 days (one day before stem cell transfusion is minus 1)based on the classic methotrexate regimen.The ABO blood group changes and DNA were tested in patients before and after ransplantation.RESULTS AND CONCLUSION:①The detection of hematopoietic reconstitution after transplantation:All patients have received hematopoietic reconstitution,with no pretreatment-related death.The white blood cells reduced to 0 after-3- +7 days of hematopoietic stem cell transplantation,and continues to(3-22)days,+10- +21 days white blood cells ＞ 1.0×109/L,+11- +51 days,platelets ＞ 20x109/L.②Incidence of GVHD:of 8 patients,there were GVHD Ⅳ grade(intestinal)in 1 case,acute graft-versus-host disease grade Ⅰ-Ⅱ in 3 cases.Above-mentioned results indicated that the further modification of BU/CTX2 regimen may be an effective pretreatment program,with a few side effects,which is better than the classic total-body irradiation/CY regimen.What's more,it is simple accurate,reliable rote of anti-leukemia and will be a safe and effective method for treating hematologic malignancies.
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OBJECTIVE:To study curative effect of the combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate as acute graft-versus-host disease(aGVHD) prophylaxis on HLA-matched unrelated donor or HLA-mismatched related donor allogenic peripheral blood stem cell transplantation(Allo-PBSCT).METHODS:Thirteen patients with haematological malignancies who underwent HLA-matched unrelated donor or HLA-mismatched related donor Allo-PBSCT with the combination of cyclosporine A as aGVHD prophylaxis at Haikou Municipal People's Hospital from September to November 2008 were selected,including 7 of unrelated donor,3 of haplotype transplantation,and 3 of 1-locus mismatched.The conditioning regimen was performed at 7 days prior to transplantation,with cyclosporine A 5-10 mg/(kg?d),12 hours per time with twice per day.From day 7 prior to transplantation,mycophenolic acid was intravenous drip once per day,then 2.5 mg/(kg?d) antithymocyte globulin at days 5-2 prior to transplantation,1.5 mg/d interleukin 11 was subcutaneous injected at day 2 prior to and 10 days after transplantation,followed by intravenous drip 15 mg/m2 amethopterin at day 1 and 10 mg/m2 at days 3,6,11 after transplantation.The drug doge was reduced and stopped gradually after 3-6 months,which could be prolonged for haplotype grafter.Recombinant human granulocyte colony-stimulating factor was injected subcutaneously at day 3 prior to transplantation,and PBSCT was collected at days 4 and 5 after medication,which was infused to patients with subclavian vein at the same day.In total(7.82-9.11)?108/kg mononuclearcell and(2.9-7.7)?106/kg CD34+ cells were infused.RESULTS:Hematopoiesis was rebuilt in all patients with 46.15%(6/13) aGVHD incidence rate,including 8 %(1/13) of Ⅲ-Ⅳ aGVHD.Up to April of 2009,all patients live and work as normal except one patient who can not visit public places.CONCLUSION:The combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate is effective in the prevention of aGVHD.
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Allotransplantation of peripheral blood-derived hemopoietic stem cells is the best therapy for acute leukemia. With increases of only-child families, sibling donors are decreasing. Moreover, the probability is low and time consuming is long to search a matched hemopoietic stem cell donor from the Chinese Marrow Donor Program. Haploidentical stem cell transplantation would bring a hope for donor resource. However, difficult transplantation and high incidence of graft versus host disease are two risks. Based on modified regimen and cyclosporine A+short-term amethopterin, mycophenolic acid, interleukin-11, anti-lymphocyte immunoglobulin and hemopoietic stem cells mobilized by recombinant human granulocyte colony-stimulating factor can prevent graft versus host disease. This therapy succeeded in two cases with no severe graft versus host disease.
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Objective To analyse the effect of mobilization and collection's time of peripheral blood stem cells(PBSC) from 8 cases of healthy donors. Methods The 10 donors were studied by self-control design.The number of aphereses was two times every donors. Healthy donors received rhG-CSF according to two different PBSC collection starting time: group 1:PBSC collection was starts 2 hours(2 h) after the fourth day or the fifth day of rhG-CSF. group 2:PBSC collection was starts 4 hours(4 h) after the fourth day or the fifth day of rhG-CSF.(The first dose of rhG-CSF was given on day 1, considering day 0 as the day before starting mobilization). In this study we have compared with two groups of apheresis product. Results The MNC count was significantly higher for donors 4 h collection (groups 2) then 2 h. ( groups 1)(P