摘要
目的了解外周血干细胞移植(PBSCT)后造血重建的规律及其影响因素。方法对24例自体和18例异体PBSCT患者移植后的血常规和骨髓变化进行动态观察及分析。结果PBSCT后患者造血重建有一定的规律性。外周血白细胞、血小板先后降至最低点,以中位时间计,中性粒细胞(ANC)计数在11d时恢复至>0.5×109/L,血小板计数在17d时恢复至>50×109/L,骨髓第28天恢复至增生活跃。两组移植后造血重建时间的差异无显著性(P>0.05)。67%(28/42例)的患者造血重建恢复迅速,33%(14/42例)有不同程度的造血延迟。在造血重建恢复迅速和延迟的患者中分别有3/28例和10/14例在半年内复发或死亡。多因素逐步回归分析结果表明,患者移植前状况、输入的CD34+细胞数量和病种3个因素对造血重建有显著影响(P<0.05)。结论PBSCT后造血重建的动态观察可以指导临床在不同时期及时给予对症治疗,还可以对植入失败作出早期预测。
Objective To explore the rule of hematopoiesis reconstruction after peripheral blood stem cell transplantation(PBSCT) and analyze the correlative factors. Methods Blood routine examination and bone marrow changes were dynamically observed and analysed in 24 autologous PBSCT patients and 18 heterologous PBSCT patients. Results The hematopoiesis reconstruction after PBSCT showed certain characteristics:WBC and platelets in the peripheral blood fell to the lowest level successively ,the neutrophils were restored to 0.5×109/L on day 11(mean value),the platelets recovered to >50×109/L on day 17, the bone marrow recovered to active proliferation on day 28. The time required for hematopoiesis reconstruction in the autologous and heterologous groups showed no significantly difference.The restitution of hematopoiesis in 67%(28/42)patients was rapid,and 33%(14/42)patients delayed to a certain degree,including 3/28 patients relapsed and 10/14 died within half a year.Multiple regression analysis showed that the status of patients before transplantation , the quantity of CD34+ cells transplanted and the type of underlying disease were the three factors affecting the hematopoiesis reconstruction Conclusions The dynamic observations on hematopoiesis reconstruction post peripheral blood stem cell transplantation can guide the symptomatic treatment in different clinical stages,and predict presence or absence of early graft failure.
出处
《上海医学》
CAS
CSCD
北大核心
2005年第5期396-398,共3页
Shanghai Medical Journal
