Đánh giá hiệu quả huy động tế bào gốc tạo máu từ tủy xương ra máu ngoại vi ở bệnh nhân đa u tủy xương

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Hồng Nga Đào, Duy Nhàn Đinh, Xuân Trường Hồ, Tuấn Khải Lý, Gia Vũ Nguyễn, Phi Song Nguyễn, Thanh Bình Nguyễn, Thị Minh Phương Nguyễn, Thuý Nga Nguyễn, Văn Tuệ Nguyễn, Thị Tuyết Nhung Phạm, Văn Hiệu Phạm

Ngôn ngữ: vie

Ký hiệu phân loại: 616.027 Experimental medicine formerly 619

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 66-74

Bộ sưu tập: Metadata

ID: 500768

Thêm vào giỏ

Đánh giá hiệu quả huy động tế bào gốc tạo máu (CD34+) từ tủy xương ra máu ngoại vi ở bệnh nhân đa u tủy xương bằng phác đồ Cyclophosphamid (Cy) kết hợp với yếu tố kích thích tăng trưởng dòng bạch cầu hạt (G-CSF) tại bệnh viện Trung ương Quân đội 108 từ năm tháng 01/2017-12/2021. Đối tượng và phương pháp: phương pháp chọn mẫu thuận tiện với 23 bệnh nhân đa u tủy xương có chỉ định huy động tế bào gốc tạo máu từ tủy xương ra máu ngoại vi để ghép tế bào gốc tạo máu tự thân hỗ trợ điều trị. Thiết kế nghiên cứu: mô tả cắt ngang hồi cứu và tiến cứu. Mỗi bệnh nhân được dùng Cyclophosphamid liều 2-3g/m2 da vào ngày N0, ngày N3 dùng G-CSF với liều 5μg/kg/12h liên tục tới khi kết thúc huy động. Các chỉ số theo dõi trong quá trình huy động bao gồm: tổng phân tích tế bào máu bằng máy đếm laser (hàng ngày)
xét nghiệm các chỉ số đông máu, sinh hóa cơ bản (trước, trong, sau quá trình huy động)
xét nghiệm tế bào gốc tạo máu ở máu ngoại vi được thực hiện sau khi dùng G-CSF khi số lượng bạch cầu đạt trên 4G/L. Tiến hành gạn tách khi số lượng tế bào gốc tạo máu ở máu ngoại vi >
10 tế bào/μl. Kết quả: Tuổi trung bình của bệnh nhân nghiên cứu là 51,78 ± 8,69 tuổi, tổng số ngày huy động trung bình là 8,96 ± 2,43 ngày và số ngày tách để đạt được liều tế bào cần thiết là 1,74 ± 0,62 ngày. Tỉ lệ huy động thành công 23/23=100%. Số lượng bạch cầu và tỉ lệ thành phần bạch cầu đều có sự thay đổi rõ rệt giữa ngày tách so với trước huy động. Có sự tương quan thuận, chặt chẽ giữa số lượng tế bào gốc tạo máu ở máu ngoại vi và số lượng tế bào gốc tạo máu trong túi sản phẩm thu được (p<
0,001, r=0,86). Giảm số lượng bạch cầu neutrophil và tiểu cầu ở các mức độ khác nhau là tác dụng phụ hay gặp nhất trong quá trình huy động và phục hồi sau khi kết thúc huy động. Kết luận: Đánh giá bước đầu quá trình huy động tế bào gốc tạo máu từ tủy xương ra máu ngoại vi ở bệnh nhân đa u tủy xương tại bệnh viện Trung ương Quân đội 108 bằng phác đồ Cyclophosphamid + G-CSF đạt hiệu quả cao và tương đối an toànTo evaluate the effectiveness of CD34+ hematopoietic stem cell mobilization from the bone marrow into peripheral blood in patients with multiple myeloma by cyclophosphamide combined with granulocyte colony-stimulating factor (G-CSF) regimen at 108 Military Central Hospital from January 2017 to December 2021. Subjects and methods: convenient sample collection method with 23 patients with multiple myeloma were indicated to mobilize CD34+ hematopoietic stem cell from bone marrow to peripheral blood for supportive treatment. The method study: cross-sectional description study. Each patient received Cyclophosphamid at a dose of 2-3g/m2 of skin on day N0. Then G-CSF was used at a dose of 5μl/kg/12h continuously from third day until the end of the mobilization period. Indicators monitored during the mobilization period included: complete blood cell count by laser counter (daily)
coagulation, basic biochemistry parameters (before, during, after the mobilization process)
CD34+ test in peripheral blood performed after G-CSF administration and peripheral blood leukocyte count above 4G/L. The apheresis process was performed when peripheral blood CD34+ was above 10 cells/μl. Resμlts: The mean age of the study subjects was 51.78 ± 8.69 years old, the average mobilization day was 8.96 ± 2.43 days and the number of days of apheresis process to achieve the required cell dose was 1.74 ± 0.62 days. Successful mobilization rate was 23/23=100%. The number and ratio of white blood cells changed markedly between the day of the apheresis process compared to before mobilization. There was a positive and close correlation between the number of CD34 in peripheral blood and the number of CD34+ in the product bag. Varying degrees of neutrophil leukopenia and thrombocytopenia were the most common adverse effects during mobilization and recovered completely after mobilization. Conclusion: Initial assessment of the process of mobilizing CD34+ hematopoietic stem cells from bone marrow to peripheral blood in patients with multiple myeloma at 108 Military Central Hospital by Cyclophosphamide + G-CSF regimen is relatively safe and achieve high efficiency.

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