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 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
特定非営利活動法人 日本小児血液・がん学会
31.10.1997
|
Online Access | Get full text |
ISSN | 0913-8706 1884-4723 |
DOI | 10.11412/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. |
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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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