【摘要】 目的　采用CD34+ 细胞体外分选技术对晚期肿瘤患者进行自体CD34+ 细胞移植 ,以降低自体移植后肿瘤复发率。方法　对 15例Ⅲ～Ⅵ期肿瘤患者 (多发性骨髓瘤 11例 ,乳癌 2例 ,非霍奇金淋巴瘤和髓母细胞瘤各 1例 )采用CliniMACS临床型细胞富集仪 ,利用磁性分选技术收集CD34+和CD34-细胞组分 ,患者于预处理后 ,输注分选后的CD34+ 细胞。结果　CD34+ 细胞体外纯化富集可使CD34-细胞获得 2 .0～ 5 .0个对数的去除 ;回输CD34+ 细胞中位数为 2 .4× 10 6/kg,CD34+ 细胞回收率为 6 4 % ,纯度为 98.2 % ;移植后白细胞恢复至 >1.0× 10 9/L和血小板 >2 0× 10 9/L的天数 (中位数 )分别为 14d和 13d。患者总体生存率 6 6 .7% (10 / 15 ) ,无疾病生存率 5 3.3% (8/ 15 )。结论　CD34+ 细胞移植后获得迅速、稳定的造血重建。体外CD34+ 细胞纯化富集后移植可望提高晚期肿瘤患者自体移植疗效。更多还原

【Abstract】 Objective To determine the clinical results of selected CD34 + cell autologous transplantation in advanced malignant tumors.Methods After pretreatment, fifteen patients aged 12 70 (49.5) years with various Stage Ⅲ or Ⅳ malignant tumors were given the sorted CD34 + cells collected by magnetic activated cell sorting (Clini MACS, Milteny Biotech, Germany). Results Peripheral blood progenitor cells (PBPC) from the patients were mobilized by chemotherapy and G CSF 5 μg/kg per day. CD34 + cells gave 2.0 5 log depletion after cell sorting, with a median yield of CD34 + selected cells of 2.4 (0.15 12.03)×10 6/kg. It gave a median recovery of 64 (52 81.4)% and median purity of 98.2(83.2 99.7)%. The median time of neutrophil recovery > 1.0×10 9/L and platelet recovery > 20×10 9/L post transplantation were 14 (8 26) days and 13 (11～35) days, respectively. On follow up of 2～33(11) months, the event free survival rate was 53.3%(8/15) and the overall survival rate was 66.7%(10/15). Conclusion Transplantation of autologous selected PBPC CD34 + cells gives prompt and stable engraftment. Selected CD34 + cell transplantation, being a safe approach, may improve the clinical outcome even in patients with advanced malignant tumors.更多还原