Факторы прогноза эффективности получения аутологичных клеток-предшественников гемопоэза для последующей трансплантации после высокодозной химиотерапии. Обзор литературы и собственные данные

Получение достаточного для быстрого и стабильного восстановления кроветворения числа клеток-предшественников гемопоэза (КПГ) является одним из основных условий безопасного проведения высокодозной химиотерапии. В статье приведен анализ существующих подходов к мобилизации и сбору КПГ, факторов, влияющих на их эффективность. На значительном собственном материале (264 пациента, прошедших процедуры мобилизации) показано, что ни один из факторов прогноза (возраст, множественные курсы химиотерапии в анамнезе, содержание CD34+ клеток в периферической крови в момент сбора и т.д.) не позволяет выявить больных с заведомо неэффективным сбором КПГ периферической крови. В то же время комбинированная мобилизация с использованием миелостимулирующих факторов (гранулоцитарный, гранулоцитарно-макрофагальный колониестимулирующие факторы) и цитостатиков (высокие дозы циклофосфамида) у больных с солидными опухолями и множественной миеломой позволяет получить наибольшее число КПГ из периферической крови.

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