中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (14): 2657-2660.doi: 10.3969/j.issn.1673-8225.2010.14.040

• 干细胞临床实践 clinical practice of stem cells • 上一篇    

低龄低体质量小儿外周血干细胞采集2例：安全性及不良反应

景  华，张金元，吕旭晶，沈旭东   

  1. 中国人民解放军第455医院干细胞移植中心，上海市  20005
  • 出版日期:2010-04-02 发布日期:2010-04-02
  • 作者简介:景 华★，女，1968年生，河北省邯郸市人，汉族，1996年上海中医药大学毕业，硕士，副主任医师，主要从事干细胞在自身免疫性疾病、肿瘤的应用研究。
  • 基金资助:

    上海市自然科学基金课题(09ZR1440000)。

Collection of peripheral blood stem cells from two infants of young age and low body mass: Safety and adverse effects

Jing Hua, Zhang Jin-Yuan, Lü Xu-jing, Shen Xu-dong   

  1. Stem Cell Transplantation Center, the 455 Hospital of Chinese PLA, Shanghai   200052, China
  • Online:2010-04-02 Published:2010-04-02
  • About author:Jing Hua★, Master, Associate chief physician, Stem Cell Transplantation Center, the 455 Hospital of Chinese PLA, Shanghai 200052, China jing-hua@citiz.net
  • Supported by:

    Supported by: Shanghai Natural Science Foundation, No.09ZR140000*

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摘要：

背景：随着外周血干细胞移植的迅速发展，目前已替代骨髓移植，成为造血干细胞移植的首选方法。由于小儿尤其是低龄低体质量幼儿自身的特殊性，外周血干细胞采集相对困难。
目的：观察采用血细胞分离机采集低龄低体质量小儿外周血造血干细胞的安全性及不良反应。
方法：采用自体造血干细胞移植治疗2例年龄低于2岁体质量低于15 kg的1型糖尿病患儿。主要方法：进行适当的心理安慰以减轻其对采集的恐惧感。采集前1周常规口服钙剂，减少采集中低钙的发生。采集前24 h禁食油腻食物，采集当天禁食牛奶，以免出现乳糜血液，影响细胞采集。1周前常规口服钙剂，减少采集中低钙的发生。常规锁骨下静脉置管。采集前给予200 mL经照射(25 Gy)的红细胞悬液充盈分离管路，以避免低血容量综合征及减少对红细胞压积的影响。设置个体化的采集参数。采集时循环血量为三、四倍体循环量，以保证足够的循环总量。分离过程中ACD/全血的比例保持在1∶11~1∶13之间，防止发生枸橼酸钠中毒等。
结果与结论：2例患儿外周血干细胞均1次采集成功，采集过程中患儿各项生命体征平稳，无不良反应。采集后单个核细胞分别达14.71×108/kg，18.82×108/kg；CD34+分别达34.13×106/kg，32.38×106/kg。只要做好充分准备，低龄低体质量幼儿外周血干细胞采集是安全可行的。

关键词: 低龄, 低体质量, 外周血干细胞, 采集, 不良反应

Abstract:

BACKGROUND: The rapidly developed transplantation of peripheral blood stem cells have been successfully used to substitute bone marrow transplantation and become the first choice method for transplantation of hemopoietic stem cells. It is relatively difficult to collect peripheral blood stem cells from young age and low body mass infants.
OBJECTIVE: To investigate the safety and adverse effects of peripheral blood stem cell collection from young age and low body mass through the use of blood cell separator.
METHODS: Two type 1 diabetes mellitus infants, aged younger than 2 years old and with body mass less than 15 kg, were treated using autologous hemopoietic stem cell transplantation. The two infants were adequately comforted to lesion the fear of collection. At 1 week prior to collection, calcium agent was orally taken to reduce the incidences of low calcium. Within 24 hours prior to collection, oily food was forbidden, and on the day of collection, milk was forbidden, to avoid chylemia, which influences blood collection. Prior to collection, 200 mL 25 Gy γ-ray radiated red blood cells suspension was injected into the tube, which was routinely placed in the subclavian vein, to avoid hypovolaemic syndrome and the effects on hematocrit. Individualized collection parameters were set. During collection, blood circulation volume was 3, 4 times of systemic blood circulation to ensure sufficient total circulation volume. During isolation, the ratio of ACD to whole blood was kept between 1: 11 and 1: 13 to prevent sodium citrate poisoning.
RESULTS AND CONCLUSION: Peripheral blood stem cells were successfully collected during first intention in each infant. During collection, stable vital signs but no adverse effects were observed. After collection, mononuclear cells weighted 14.71×108/kg and 18.82×108/kg respectively, and CD34+ cells were about 34.13×106/kg and 32.38×106/kg, respectively in each infant. Therefore, it is feasible to collect peripheral blood stem cells from infants of young age and low body mass under sufficient psychological preparation.

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