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目的 观察化疗对造血祖细胞、造血微环境的影响 ,化疗后回输体外扩增的自体骨髓基质细胞 (ABMSC)对造血功能恢复的作用。方法 对化疗患者进行骨髓CFU GM、CFU E、BFU E及基质细胞集落 (CFU F)培养、长期骨髓培养 ,观察基质层融合情况 ,计算基质层覆盖率及完全融合时间。长期化疗的 10例患者进行自身前后对照 ,在同一化疗方案下 ,单纯化疗与化疗后回输体外扩增的ABMSC[(1.1～ 8.7)× 10 8/次 ]作对比 ,观察两者造血恢复情况。结果 ①长期化疗组的CFU GM、BFU E、CFU E、CFU F显著低于正常对照组及短期化疗组 ,后两组差异无显著性 ;②三组基质层覆盖率及完全融合时间差异无显著性 ;③长期化疗组ABMSC输注后的CFU GM、CFU E、BFU E、CFU F显著高于未输注组 ;④输注ABMSC后白细胞计数及血小板计数降至最低点的值显著高于未输注组 ,前者白细胞计数及血小板计数恢复正常时间较后者明显缩短 ;⑤基质细胞回输过程及输后临床观察无不良反应。结论 长期化疗明显损伤造血祖细胞、基质祖细胞 ,但对骨髓基质细胞融合功能无明显影响 ,化疗后给予ABMSC可加速造血功能的恢复。
Objective To observe the effect of chemotherapy on hematopoietic progenitor cells and hematopoietic microenvironment, and to regenerate the effect of autologous bone marrow stromal cells (ABMSCs) on the recovery of hematopoietic function after chemotherapy. Methods Bone marrow CFU GM, CFU E, BFU E, stromal cell colony (CFU F) culture, and long-term bone marrow culture were performed in patients with chemotherapy. The stromal layer fusion was observed, and the coverage of matrix layer and complete fusion time were calculated. The 10 patients with long-term chemotherapy performed self-contrast and post-contrast controls. Under the same chemotherapy regimen, after repeated chemotherapy and chemotherapy, ex vivo expansion of ABMSC [(1.1 to 8.7) × 10 8/times] was compared to observe the recovery of both hematopoiesis. . Results 1 The CFU GM, BFU E, CFU E, and CFU F in the long-term chemotherapy group were significantly lower than those in the normal control group and the short-term chemotherapy group, and there was no significant difference between the two groups. 2 There was no significant difference in the coverage of the stromal layer and the complete fusion time between the three groups. Sex; 3 long-term chemotherapy group after infusion of ABMSC CFU GM, CFU E, BFU E, CFU F significantly higher than the non-infusion group; 4 infusion of ABMSC leukocyte count and platelet count to the lowest point of the value is significantly higher than In the infusion group, the time for recovery of white blood cell count and platelet count in the former was significantly shorter than that in the latter group; 5 there was no adverse reaction in the stromal cell reinfusion process and clinical observation after transfusion. Conclusion Long-term chemotherapy significantly impairs hematopoietic progenitor cells and stromal progenitor cells, but has no obvious effect on the fusion function of bone marrow stromal cells. Administration of ABMSC after chemotherapy can accelerate the recovery of hematopoietic function.