| 词条 | Peripheral stem cell transplantation |
| 释义 |
| name = Peripheral stem cell transplantation | synonym = | image = File:Hematopoietic stem cell.jpg|thumb| | caption = Peripheral blood stem cells] | alt = | pronounce = | specialty = hematology | synonyms = | ICD10 = | ICD9 = | ICD9unlinked = | CPT = | MeshID = | LOINC = | other_codes = | MedlinePlus = | eMedicine = }}Peripheral blood stem cell transplantation (PBSCT), also called "Peripheral stem cell support",[1] is a method of replacing blood-forming stem cells destroyed, for example, by cancer treatment. PBSCT is now a much more common procedure than its bone marrow harvest equivalent, this is in-part due to the ease and less invasive nature of the procedure.[2][3] Studies suggest that PBSCT has a better outcome in terms of the number of hematopoietic stem cell (CD34+ cells) yield.[4] Immature blood cells hematopoietic stem cells in the circulating blood that are similar to those in the bone marrow are collected by apheresis from a potential donor (PBSC collection). The product is then administered intravenously to the patient after treatment. The administered hematopoietic stem cells then migrate to the recipient's bone marrow, a process known as stem cell homing, where the transplanted cells override the previous bone marrow. This allows the bone marrow to recover, proliferate and continue producing healthy blood cells. The transplantation may be autologous (an individual's own blood cells saved earlier), allogeneic (blood cells donated by someone else with matching HLA), or syngeneic (blood cells donated by an identical twin). The apheresis procedure typically lasts for 4–6 hours, depending on the donor's total blood volume.[5] Preparation prior to PBSC CollectionGCSFGranulocyte colony stimulating factor (GCSF) are naturally occurring glycoproteins that stimulate white blood cell proliferation. Filgrastim is a synthetic form of GCSF produced in E.coli.[6] PBSC donors are given a course of GCSF prior to PBSC collection, this ensures a better outcome, as stem cell proliferation increases, thus increasing the number of peripheral stem cells in circulation. The course is usually given over a 4-day period prior to PBSC collection.[7] Mild bone pain usually results due to the excessive stem cell crowding within the bone marrow. ComplicationsSince allogeneic PBSCT involves transformation of blood between different individuals, this naturally carries more complications than autologous PBSCT.[8] For example, calculations must be made to ensure consistency in the amount of total blood volume between the donor and recipient. If the total blood volume of the donor is less than that of the recipient (such as when a child is donating to an adult), multiple PBSCT sessions may be required for adequate collection. Performing such a collection in a single setting could result in risks such as hypovolemia, which could lead to cardiac arrest, thus health care providers must exercise careful precaution when considering donor-recipient matching in allogeneic PBSCT[9] References1. ^{{cite web|title=Dictionary of Cancer Terms|url=http://www.cancer.gov/dictionary?cdrid=45827|accessdate=2 March 2012}} 2. ^{{cite web|title=Stem Cell Transplant (Peripheral Blood, Bone Marrow, and Cord Blood Transplants)|url=http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/BoneMarrowandPeripheralBloodStemCellTransplant/stem-cell-transplant-stem-cell-sources|accessdate=4 March 2012}} 3. ^{{cite web|title=Peripheral Blood Stem Cell Harvest|url=http://www.explorestemcells.co.uk/peripheralbloodstemcellharvest.html|accessdate=4 March 2012}} 4. ^{{cite journal|last=Singhal|first=S |author2=Powles, R |author3=Kulkarni, S |author4=Treleaven, J |author5=Sirohi, B |author6=Millar, B |author7=Shepherd, V |author8=Saso, R |author9=Rowland, A |author10=Long, S |author11=Cabral, S |author12=Horton, C |author13=Mehta, J|title=Comparison of marrow and blood cell yields from the same donors in a double-blind, randomized study of allogeneic marrow vs blood stem cell transplantation.|journal=Bone marrow transplantation|date=March 2000|volume=25|issue=5|pages=501–5|pmid=10713626|doi=10.1038/sj.bmt.1702173}} 5. ^{{cite web|title=Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation|url=http://www.cancer.gov/cancertopics/factsheet/Therapy/bone-marrow-transplant}} 6. ^{{cite journal|last=Welte|first=K|author2=Gabrilove, J |author3=Bronchud, MH |author4=Platzer, E |author5=Morstyn, G |title=Filgrastim (r-metHuG-CSF): the first 10 years.|journal=Blood|date=Sep 15, 1996|volume=88|issue=6|pages=1907–29|pmid=8822908}} 7. ^{{cite web|title=G-CSF Administration|url=http://www.leukemiabmtprogram.org/patients_and_family/stem_cell_and_marrow_donors/pbsc_collection_in-depth/gcsf_administration.html}} 8. ^{{cite journal|last=Cutler|first=C|author2=Antin, JH|title=Peripheral blood stem cells for allogeneic transplantation: a review.|journal=Stem Cells|year=2001|volume=19|issue=2|pages=108–17|pmid=11239165|doi=10.1634/stemcells.19-2-108}} 9. ^{{cite journal|last=Sevilla|first=J |author2=Plaza, SF |author3=González-Vicent, M |author4=Lassaletta, A |author5=Ramírez, M |author6=Madero, L |author7=Díaz, MA|title=PBSC collection in extremely low weight infants: a single-center experience.|journal=Cytotherapy|year=2007|volume=9|issue=4|pages=356–61|pmid=17573611|doi=10.1080/14653240701320270}} External links
5 : Transplantation medicine|Lymphology|Hematology|Surgical oncology|Stem cells |
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