凍結保存細胞から純化を行い自家末梢血CD34陽性細胞選択移植を施行した悪性リンパ腫 Successful hematologic reconstitution using CD34^+ cells positively selected from cryopreserved autologous peripheral blood stem cells in a patient with malignant lymphoma

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凍結細胞からのCD34<sup>+</sup>細胞純化は,凝集塊の形成による回収率の低下などのため,臨床応用されている報告例は少ない。われわれは,悪性リンパ腫の一例に,凍結細胞からCD34<sup>+</sup>細胞の純化を行い自家末梢血CD34<sup>+</sup>細胞選択移植を施行した。症例は49歳,女性。NHL (follicular mixed, B cell, stageIV<sub>A</sub>)の診断で,化学療法7コース後にPBSCを採取し凍結保存した。しかし採取細胞の検索にてIgH遺伝子再構成を認めたため,大量化学療法による前処置後に,凍結保存していたPBSCからCD34<sup>+</sup>細胞の純化を行い移植した(CD34<sup>+</sup>細胞数=1.97×10<sup>6</sup>/kg, CD34陽性率=72.2%, CD34<sup>+</sup>細胞回収率=65.0%)。移植に伴う重篤な副作用は認められなかった。また,移植後11日目に顆粒球数>500/μ<i>l</i>, 21日目に血小板数>50,000/μ<i>l</i>となり凍結細胞からの純化移植においても通常のPBSCTと比べ生着の遅延はなかった。

Clinical use of CD34<sup>+</sup> cells positively selected from cryopreserved peripheral blood stem cells (PBSC) has been limited, and there have been only a few reports of this procedure, mainly because clump formation decreases the proportion of CD34<sup>+</sup> cells that can be recovered. A 49-year-old Japanese woman with non-Hodgkin's lymphoma (NHL) (follicular mixed, B cell, stage IV<sub>A</sub>) was treated with seven cycles of conventional chemotherapy and achieved partial remission. During hematopoietic recovery after the seventh course of chemotherapy, PBSC were harvested by continuous leukapheresis and cryopreserved. However, clonal rearrangement of the immunoglobulin heavy chain gene was detected in the PBSC by Southern blot analysis. After high-dose chemotherapy, CD34<sup>+</sup> cells were positively immunoselected from the cryopreserved PBSC and infused into the patient at 1.97×10<sup>6</sup>/kg. The overall purity and recovery rate of the CD34<sup>+</sup> cells were 72.2% and 65.0%, respectively. There were no severe adverse effects after PBSC transplantation, and the time required for recovery of neutrophils to over 0.5×10<sup>9</sup>/<i>l</i> and platelets to over 50×10<sup>9</sup>/<i>l</i> was 11 and 21 days, respectively. Transplantation of CD34<sup>+</sup> cells positively selected from cryopreserved PBSC provides engraftment ability similar to that of unmanipulated PBSC.

収録刊行物

  • 臨床血液

    臨床血液 41(8), 681-686, 2000-08-30

    The Japanese Society of Hematology

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各種コード

  • NII論文ID(NAID)
    10008038151
  • NII書誌ID(NCID)
    AN00252940
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    04851439
  • NDL 記事登録ID
    6295811
  • NDL 雑誌分類
    ZS21(科学技術--医学--内科学)
  • NDL 請求記号
    Z19-295
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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