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目的采用 CD34~+细胞体外分选技术对非霍奇金淋巴瘤(NHL)患者进行自体外周血CD34~+细胞移植,观察其临床疗效。方法 5例 NHL 患者,女3例,男2例;中位年龄29岁;T 细胞NHL 3例,弥漫大 B 细胞 NHL 1例,真性组织细胞型 NHL 1例;临床分期ⅡA 2例,IV B 3例;移植前4例处首次完全缓解,1例为部分缓解。采用 Clini MACS 临床型磁性细胞分离器收集 CD34~+和CD34~-细胞组分,患者于预处理后输注分选的 CD34~+细胞。结果 Clini MACS 体外分选可去除3.3个对数级 CD34~-细胞;回输 CD34~+细胞中位数为2.0×10~6/kg;CD34~+回收率为52%,CD34~+细胞纯度为86%;移植后白细胞恢复至>0.5×10~9/L 和血小板>20×10~9/L 天数(中位数)分别为12 d 和19 d。患者总体生存率和无病生存率均为4/5,1年生存率为4/5,估计5年生存率为75%。结论NHL 患者自体外周血 CD34~+细胞移植后可获得迅速稳定的造血重建,体外 CD34~+细胞纯化富集后移植可望提高 NHL 患者自体移植疗效。
OBJECTIVE: To study the clinical efficacy of autologous peripheral blood CD34 + cell transplantation in patients with non-Hodgkin’s lymphoma (NHL) using CD34 + cell sorting technology in vitro. Methods Five NHL patients were enrolled, including 3 females and 2 females. The median age was 29 years old. Three cases of T cell NHL, one case of diffuse large B cell NHL and one case of true cell type NHL. The clinical stage ⅡA and IV B 3 cases; 4 cases before transplantation for the first time complete remission, 1 case of partial remission. CD34 + and CD34 ~ - cell fractions were collected using a Clini MACS clinical magnetic separator and patients were infused with sorted CD34 + cells after pretreatment. Results Clini MACS could remove 3.3 logarithmic CD34 ~ - cells in vitro. The median of CD34 + cells was 2.0 × 10 ~ 6 / kg. The recovery of CD34 + was 52%. The purity of CD34 + cells Was 86%. The days (median) of leukocyte recovery to> 0.5 × 10 ~ 9 / L and platelets> 20 × 10 ~ 9 / L after transplantation were 12 d and 19 d, respectively. Patients overall survival and disease-free survival rates were 4/5, 1-year survival rate was 4/5, 5-year estimated survival rate was 75%. Conclusions Rapid and stable hematopoietic reconstitution can be achieved in patients with NHL after autologous peripheral blood CD34 + cells transplantation. Purification and enrichment of CD34 + cells in vitro can improve the autologous transplantation in NHL patients.