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말초혈액 조혈모세포 채혈 및 이식 후 생착에 관한 연구
손계성 ( Gye Sung Son ),권흥만 ( Heung Man Kwon ),권계철 ( Gye Cheol Kwon ) 대한임상검사과학회 2006 대한임상검사과학회지(KJCLS) Vol.38 No.1
Peripheral bood stem cell collection (PBSCC), including peripheral blood stem cell transplantation (PBSCT), has been utilized worldwide as a very beneficial treatment method instead of allogenic Bone Marrow Transplantation (BMT) because it has many advantages such as rapid bone marrow engraftment and hematopoietic recovery, easy and safe accessibility and lower risk of rejection compared with allogenic BMT. In order to identify most the observable parameter in PBSCC, we analyzed various hematological parameters before and after PBSCC, and evaluated the correlation between the time of bone marrow engraftment and the number of CD34+ cells. Thirteen patients, who underwent 54 PBSCCs from January, 2003 to August, 2004 at Chungnam National University Hospital due to various systemic neoplasms, were analyzed in aspects of various hematological parameters including CD34+ cells using by Flow Cytometry (FCM). PBSCC harvests are described below: Mononuclear cells (MNC) 2.3 ± 1.4×108/kg and CD34+ cells 0.63 ± 0.35×106/kg on average, respectively. There was a statistical significance in Hb and Hct before and after PBSCC, but not in WBC and platelet counts. The period to reach the hematological bone marrow engraftment was 13.4(10~21) days and 19.5(11~38) days according to the criteria of absolute neutrophile counts (ANC) ≥ 500/uL and platelet counts ≥50,000/μL in peripheral blood, respectively. There was a significant correlation between the numbers of CD34+ cell and ANC (p<0.05), and a borderline significance between MNC and ANC (p=0.051). We found that a group of patients, who were infused with CD34+ cells more than 3.5×106/kg, reached more rapidly the period of bone marrow engraftment in platelet counts (p=0.040). This present study suggested that Hb and Hct were the most useful parameters and should be closely monitored before and after PBSCC, that a PBSCT with the dosage of more than 3.5×106/kg of CD34+ cells was needed to perform successful bone marrow engraftment, and additionally that platelet counts could be more useful in indicating bone marrow engraftment than ANC.
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