小児急性白血病, 悪性リンパ腫に対する同種末梢血幹細胞移植

4例の小児急性白血病, 悪性リンパ腫症例に対し, 計5回の同種末梢血幹細胞移植を施行した.ドナーはHLA一致同胞で, 末梢血幹細胞採取のためドナーに5-10μg/kgのG-CSFを5日間投与し, 5, 6日目にapheresisを行った.G-CSF投与, apheresisに伴う重篤な副作用はみられなかった.移植前処置後, 患児にCFU-GMとして2.7×105/kg (中央値) の同種末梢血幹細胞を輸注した.移植後15日で好中球数500/μ1, 14日で血小板数2万/μ1に達し (いずれも中央値), PHA, ConA刺激に対するリンパ球幼弱化試験は1カ月後には正常値を示した.同種末梢血幹細...

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Published in日本小児血液学会雑誌 Vol. 11; no. 5; pp. 356 - 362
Main Authors 甲斐, 純夫, 松田, 基, 松山, 秀介, 関口, 晴之, 渡辺, 由佳, 後藤, 裕明, 後藤, 晶子, 半沢, 典生, 船曳, 哲典, 生田, 孝一郎, 佐々木, 秀樹
Format Journal Article
LanguageJapanese
Published 特定非営利活動法人 日本小児血液・がん学会 31.10.1997
Online AccessGet full text
ISSN0913-8706
1884-4723
DOI10.11412/jjph1987.11.356

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Abstract 4例の小児急性白血病, 悪性リンパ腫症例に対し, 計5回の同種末梢血幹細胞移植を施行した.ドナーはHLA一致同胞で, 末梢血幹細胞採取のためドナーに5-10μg/kgのG-CSFを5日間投与し, 5, 6日目にapheresisを行った.G-CSF投与, apheresisに伴う重篤な副作用はみられなかった.移植前処置後, 患児にCFU-GMとして2.7×105/kg (中央値) の同種末梢血幹細胞を輸注した.移植後15日で好中球数500/μ1, 14日で血小板数2万/μ1に達し (いずれも中央値), PHA, ConA刺激に対するリンパ球幼弱化試験は1カ月後には正常値を示した.同種末梢血幹細胞を施行した4例は全例原疾患の再発なく生存中である (移植後48-259日).同種末梢血幹細胞の採取は安全に施行可能であり, 移植後の生着, 細胞性免疫機能の回復は速やかであった.しかし, 4例中2例に慢性GVHDがみられ, 自験例の同種BMTよりも慢性GVHDの発症頻度が高かった.
AbstractList 4例の小児急性白血病, 悪性リンパ腫症例に対し, 計5回の同種末梢血幹細胞移植を施行した.ドナーはHLA一致同胞で, 末梢血幹細胞採取のためドナーに5-10μg/kgのG-CSFを5日間投与し, 5, 6日目にapheresisを行った.G-CSF投与, apheresisに伴う重篤な副作用はみられなかった.移植前処置後, 患児にCFU-GMとして2.7×105/kg (中央値) の同種末梢血幹細胞を輸注した.移植後15日で好中球数500/μ1, 14日で血小板数2万/μ1に達し (いずれも中央値), PHA, ConA刺激に対するリンパ球幼弱化試験は1カ月後には正常値を示した.同種末梢血幹細胞を施行した4例は全例原疾患の再発なく生存中である (移植後48-259日).同種末梢血幹細胞の採取は安全に施行可能であり, 移植後の生着, 細胞性免疫機能の回復は速やかであった.しかし, 4例中2例に慢性GVHDがみられ, 自験例の同種BMTよりも慢性GVHDの発症頻度が高かった.
Author 甲斐, 純夫
後藤, 裕明
半沢, 典生
船曳, 哲典
関口, 晴之
渡辺, 由佳
松山, 秀介
後藤, 晶子
生田, 孝一郎
佐々木, 秀樹
松田, 基
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References 1) Russell NH, Hunter A, Rogers S, et al : Peripheral blood stem cells as an alternative to marrow for allogeneic transplantation. Lancet 341 : 1482, 1993
24) Pan L, Delmonte J Jr, Jalonen CK, et al : Pretreatment of donor mice with granulocyte colony-stimulating factor polarizes donor T lymphocytes toward type-2 cytokine production and reduces severity of experimental graft versus host disease. Blood 86 : 4422-4429, 1995
12) Weaver CH, Longin K, Buckner CD, et al : Lymphocyte content in peripheral blood mononuclear cells collected after the administration of recombinant human granulocyte colony-stimulating factor. Bone Marrow Transplant 13 : 411-415, 1994
13) Sica S, Rutella S, Mario AD, et al : rhG-CSF in healthy donors : Mobilization of peripheral hemopoietic progenitors and effect on peripheral blood leukocytes. J Hematother 5 : 391-397, 1996
5) Russell JA, Luider J, Weaver M, et al : Collection of progenitor cells for allogeneic transplantation from peripheral blood of normal donors. Bone Marrow Transplant 15 : 111-115, 1995
9) Russell JA, Brown C, Bowen T, et al : Allogeneic blood cell transplants for haematological malignancy : preliminary comparison of outcomes with bone marrow transplantation. Bone Marrow Transplant 17 : 703-708, 1996
25) Majolino I, Saglio G, Scime R, et al : High incidence of chronic GVHD after primary allogeneic peripheral blood stem cell transplantation in patients with hematologic malignancies. Bone Marrow Transplant 17 : 555-560, 1996
7) Schmitz N, Dreger P, Suttorp M, et al : Primary transplantation of allogeneic peripheral blood progenitor cells mobilized by Filgrastim (granulocyte colonystimulating factor). Blood 85 : 1666-1672, 1995
14) Waller CF, Bertz H, Wenger MK, et al : Mobilization of peripheral blood progenitor cells for allogeneic transplantation : efficacy and toxicity of a high-dose rhG-CSF regimen. Bone Marrow Transplant 18 : 279-283, 1996
23) Bensinger WI, Buckner CD, Shannon-Dorcy K, et al : Transplantation of allogeneic CD34+ peripheral blood stem cells in patients with advanced hematologic malignancy. Blood 88 : 4132-4138, 1996
20) Ottinger HD, Beelen DW, Sceulen B, et al : Improved immune reconstitution after allotransplantation of peripheral blood stem cells instead of bone marrow. Blood 88 : 2775-2779, 1996
17) Molineux G, Pojda Z, Hampson IN, et al : Transplantation potential of peripheral blood cells induced by granulocyte colony-stimulating factor. Blood 76 : 2153-2158, 1990
3) Bensinger WI, Clift R, Martin P, et al : Allogeneic peripheral blood cell transplantation in patients with advanced hematologic malignancies : A retrospective comparison with marrow transplantation. Blood 88 : 2794-2800, 1996
15) Chatta GS, Price TH, Allen RC, et al : Effects of in vivo recombinant methionyl human granulocyte colony-stimulating factor on neutrophil response and peripheral blood colony-forming cells in healthy young and elderly adult volunteers. Blood 84 : 2923-2929. 1994
2) Urbano-Ispizua A, Solano C, Brunet S, et al : Allogeneic peripheral blood progenitor cell transplantation : analysis of short-term engraftment and acute GVHD incidence in 33 cases. Bone Marow Transplant 18 : 35-40, 1996
16) 大久保泰宏, 中村堅次 : MACOP-B, rG-CSF投与を契機に間質性肺炎を発症したと考えられた悪性リンパ腫の2症例.臨床血液34 : 473-477, 1993
10) Deger P, Haferlach T, Eckstein V, et al : G-CSF-mobilized peripheral blood progenitor cells for allogeneic transplantation : safety, kinetics of mobilization, and composition of the graft. Br J Haematol 87 : 609-613, 1994
18) Pettengell R, Testa NG, Swindell R, et al : Transplantation potential of hematopoietic cells released into the circulation during routine chemotherapy for non-Hodgkin's lymphoma. Blood 82 : 2239-2248, 1993
4) Russell JA, Bowen T, Brown C, et al : Second allogeneic transplants for leukemia using blood instead of bone marrow as a source if hemopoietic cells. Bone Marrow Transplant 18 : 501-505, 1996
6) Bensinger WI, Weaver CH, Appelbaum FR, et al : Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor. Blood 85 : 1655-1658, 1995
11) Hoglund M, Smedmyr B, Simonsson B, et al : Dosedependent mobilization of haematopoietic progenitor cells in healthy volunteers receiving glycosylated rHuG-CSF. Bone Marrow Transplant 18 : 19-27, 1996
22) Schmindt-Wolf IGH, Dejbakhshjones S : T-cell subsets and supressor cells in human bone marrow. Blood 80 : 3242-3250, 1992
21) Dreger P, Oberboster K, Schmitz N : PBPC grafts from healthy donors : analysis of CD34+ and CD3+ subpopulations. Bone Marrow Transplant 17 (Suppl 2) : S22-S27, 1996
8) Korbling M, Przepiorka D, Huh YO, et al : Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma : Potential advantage of blood over marrow allografts. Blood 85 : 1659-1665, 1995
19) Baumann I, Testa NG, Lange C, et al : Haemopoietic cells mobilised into the circulation by lenograstim as alternative to bone marrow for allogeneic transplants. Lancet 341 : 369, 1993
References_xml – reference: 10) Deger P, Haferlach T, Eckstein V, et al : G-CSF-mobilized peripheral blood progenitor cells for allogeneic transplantation : safety, kinetics of mobilization, and composition of the graft. Br J Haematol 87 : 609-613, 1994
– reference: 11) Hoglund M, Smedmyr B, Simonsson B, et al : Dosedependent mobilization of haematopoietic progenitor cells in healthy volunteers receiving glycosylated rHuG-CSF. Bone Marrow Transplant 18 : 19-27, 1996
– reference: 16) 大久保泰宏, 中村堅次 : MACOP-B, rG-CSF投与を契機に間質性肺炎を発症したと考えられた悪性リンパ腫の2症例.臨床血液34 : 473-477, 1993
– reference: 7) Schmitz N, Dreger P, Suttorp M, et al : Primary transplantation of allogeneic peripheral blood progenitor cells mobilized by Filgrastim (granulocyte colonystimulating factor). Blood 85 : 1666-1672, 1995
– reference: 3) Bensinger WI, Clift R, Martin P, et al : Allogeneic peripheral blood cell transplantation in patients with advanced hematologic malignancies : A retrospective comparison with marrow transplantation. Blood 88 : 2794-2800, 1996
– reference: 8) Korbling M, Przepiorka D, Huh YO, et al : Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma : Potential advantage of blood over marrow allografts. Blood 85 : 1659-1665, 1995
– reference: 20) Ottinger HD, Beelen DW, Sceulen B, et al : Improved immune reconstitution after allotransplantation of peripheral blood stem cells instead of bone marrow. Blood 88 : 2775-2779, 1996
– reference: 21) Dreger P, Oberboster K, Schmitz N : PBPC grafts from healthy donors : analysis of CD34+ and CD3+ subpopulations. Bone Marrow Transplant 17 (Suppl 2) : S22-S27, 1996
– reference: 2) Urbano-Ispizua A, Solano C, Brunet S, et al : Allogeneic peripheral blood progenitor cell transplantation : analysis of short-term engraftment and acute GVHD incidence in 33 cases. Bone Marow Transplant 18 : 35-40, 1996
– reference: 19) Baumann I, Testa NG, Lange C, et al : Haemopoietic cells mobilised into the circulation by lenograstim as alternative to bone marrow for allogeneic transplants. Lancet 341 : 369, 1993
– reference: 12) Weaver CH, Longin K, Buckner CD, et al : Lymphocyte content in peripheral blood mononuclear cells collected after the administration of recombinant human granulocyte colony-stimulating factor. Bone Marrow Transplant 13 : 411-415, 1994
– reference: 14) Waller CF, Bertz H, Wenger MK, et al : Mobilization of peripheral blood progenitor cells for allogeneic transplantation : efficacy and toxicity of a high-dose rhG-CSF regimen. Bone Marrow Transplant 18 : 279-283, 1996
– reference: 25) Majolino I, Saglio G, Scime R, et al : High incidence of chronic GVHD after primary allogeneic peripheral blood stem cell transplantation in patients with hematologic malignancies. Bone Marrow Transplant 17 : 555-560, 1996
– reference: 9) Russell JA, Brown C, Bowen T, et al : Allogeneic blood cell transplants for haematological malignancy : preliminary comparison of outcomes with bone marrow transplantation. Bone Marrow Transplant 17 : 703-708, 1996
– reference: 13) Sica S, Rutella S, Mario AD, et al : rhG-CSF in healthy donors : Mobilization of peripheral hemopoietic progenitors and effect on peripheral blood leukocytes. J Hematother 5 : 391-397, 1996
– reference: 22) Schmindt-Wolf IGH, Dejbakhshjones S : T-cell subsets and supressor cells in human bone marrow. Blood 80 : 3242-3250, 1992
– reference: 4) Russell JA, Bowen T, Brown C, et al : Second allogeneic transplants for leukemia using blood instead of bone marrow as a source if hemopoietic cells. Bone Marrow Transplant 18 : 501-505, 1996
– reference: 6) Bensinger WI, Weaver CH, Appelbaum FR, et al : Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor. Blood 85 : 1655-1658, 1995
– reference: 24) Pan L, Delmonte J Jr, Jalonen CK, et al : Pretreatment of donor mice with granulocyte colony-stimulating factor polarizes donor T lymphocytes toward type-2 cytokine production and reduces severity of experimental graft versus host disease. Blood 86 : 4422-4429, 1995
– reference: 5) Russell JA, Luider J, Weaver M, et al : Collection of progenitor cells for allogeneic transplantation from peripheral blood of normal donors. Bone Marrow Transplant 15 : 111-115, 1995
– reference: 18) Pettengell R, Testa NG, Swindell R, et al : Transplantation potential of hematopoietic cells released into the circulation during routine chemotherapy for non-Hodgkin's lymphoma. Blood 82 : 2239-2248, 1993
– reference: 23) Bensinger WI, Buckner CD, Shannon-Dorcy K, et al : Transplantation of allogeneic CD34+ peripheral blood stem cells in patients with advanced hematologic malignancy. Blood 88 : 4132-4138, 1996
– reference: 15) Chatta GS, Price TH, Allen RC, et al : Effects of in vivo recombinant methionyl human granulocyte colony-stimulating factor on neutrophil response and peripheral blood colony-forming cells in healthy young and elderly adult volunteers. Blood 84 : 2923-2929. 1994
– reference: 1) Russell NH, Hunter A, Rogers S, et al : Peripheral blood stem cells as an alternative to marrow for allogeneic transplantation. Lancet 341 : 1482, 1993
– reference: 17) Molineux G, Pojda Z, Hampson IN, et al : Transplantation potential of peripheral blood cells induced by granulocyte colony-stimulating factor. Blood 76 : 2153-2158, 1990
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Snippet 4例の小児急性白血病, 悪性リンパ腫症例に対し, 計5回の同種末梢血幹細胞移植を施行した.ドナーはHLA一致同胞で, 末梢血幹細胞採取のためドナーに5-10μg/kgのG-CSFを5日間...
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Title 小児急性白血病, 悪性リンパ腫に対する同種末梢血幹細胞移植
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