ABSTRACT: The mobilization of hematopoietic stem cells into the circulation has improved the
efficiency of their collection. Transplantation of movilized blood stem cells to
patients with different haematologic diseases results in a faster pace of
hematopoietic recovery than transplantation of marrow derived stem cells.
Quantification of CD34+ mononuclear cells is the most important quality control
measure for hematopoietic stem cell (HSC) transplantation. A fraction of CD34+
cells also expressed the CD133 antigen. These cells constituted a group of earlier,
less-differentiated HSCs with a potentially higher capacity for engraftment. The
total number of CD34+ cells peripheral HSCs and the fraction of these cells that
coexpressed CD133+ was determined before and after automated collection by
leukapheresis, as well as the effect of HSC CD133+ dose on hematopoiesis
recovery. In this work loocked the relation between the quantity of progenitor cells
CD133+ with the period of graft in the allogeneic transplant.
STUDY DESIGN AND METHODS:
Granulocyte-colony-stimulating factor mobilization of HSCs from the bone marrow
to the peripheral blood (PB) of allogeneic donors was followed by automated
collection through leukapheresis on the fifth day. Quantification of CD34+, CD38+
and CD133+ cells was performed on PB before collection and in the hematopoietic
graft by flow cytometry.
RESULTS: Twenty six patients with different haematologics disease were studied.
The average age was 37 years. The cell colonies CD34+38-, 34+38+, 34+133-,
133+38-, 133+38+, 133+34-, 133+34+ were determined in basal samples
collected from patients and donators, mobilized and donor’s harvest. There was a
significant difference after the mobilization in all the cellular population. The
average dosis of CD34+ infused was 8.9666 cells X106/kg and 5.885 cells
X106/kg of CD133+. With this dosis of CD34+ neutrophils were grafted on the
thirteenth day, platelets and reticulocytes on the fourteenth. Patients that
received a dosis of 8.966 cells X106/kg of CD34+ showed death (P=0.077). The
presence of graft versus host disease (GVHD) was higher with high dosis of
implated stem cell. The GVHD type I and II were the most frequent among 35% of
the patients. The middle of overall survival was of 363 days postransplant in
average and 295 days of free of disease survival.
CONCLUSION: A significant mobilization of pheripherical blood was obtained from
all the population analized using G-CSF with a dosis of 10 μg/kg/day was
administered subcutaneously for five consecutive days.
With the average infused dosis of CD34+=8.966 cells X106/kg and of CD133+
=5.885 cells X106/kg., the graft was for the myeloid, platelets and erythroid series
was gotten between the 12 and the 14 day. However, it was found that the dosis
did not have any influence with the period of the graft. With minor dosis of 7.2
cells X106/kg of CD34+, 64% of the patients did not present GVHD and the other
36% presented only the types I and II. With dosis less than 3.0 cells X106/kg of
CD133+, it was found that 67% of the patients did not present GVHD and the other
33% presented GVHD type I, II and III. Regarding the overall survival, a medium
of 363 days was obtained and for the free of disease survival it was 295 days.
RESUMEN: La movilización de células tallo hematopoyéticas dentro de la
circulación sanguínea ha mejorado la eficiencia de su colección. El trasplante de células
tallo movilizadas para pacientes con diferentes enfermedades hematológicas resulta un
paso rápido para la recuperación hematopoyética que deriva de células tallo de médula
trasplantada.
La cuantificación de células mononucleares CD34+ es la medida más importante de
control de calidad para el trasplante de células tallo hematopoyética (CTH). Estas células
constituyen un grupo primitivo de células tallo menos diferenciadas, con una potencial y
elevada capacidad de injerto. La cantidad total de células tallo hematopoyéticas
periféricas CD34+ y la fracción de estas células que coexpresan CD133+, fue
determinado antes y después de la colección automatizada por leucoaféresis, así como el
efecto de la dosis de las células tallo CD133+.en la recuperación hematopoyética En este
trabajo se observó la relación entre la cantidad de células progenitoras CD133+ con el
periodo de injerto en el trasplante alogénico.
