Periferik Hematopoietik Kök Hücre Nakli Yapılan Hastalarda Kök Hücre Mobilizasyonunu Etkileyen Faktörler

Abstract

Amaç: Otolog kök hücre transplantasyonunun başarısı yeterli sayıda kök hücrenin infüzyonuna bağlıdır. Bu nedenle kök hücre mobilizasyonunu etkileyen faktörlerin tanımlanması önem taşımaktadır. Çalışmamızın amacı, otolog kök hücre nakli uygulanan hastalarda kök hücre mobilizasyonunu etkileyen faktörleri belirlemektir.

Hastalar ve Yöntemler: Otolog kök hücre nakli yapılan 143 hasta ve bu hastalara uygulanan 169 kök hücre aferez işlemi retrospektif olarak değerlendirildi.

Bulgular: Kök hücre mobilizasyonu için 89 (%52.7) hastada Filgrastim, 80 (%47.3) hastada Lenograstim kullanıldı. Aferez işleminde 69 (%40.8) hastada Fresenius, 100 (%59.2) hastada Haemonetics cihazı kullanıldı. Tek değişkenli analizlerde tanı (p=0.005), aferez öncesi tedavi sayısı (p:0.0004), tanıdan afereze kadar geçen süre (p:0.02), aferezin 1. günündeki lökosit ve CD34+ hücre sayısı (p:0.0001; p:0.0005), filgrastim kullanımı (p=0.00004) ve fresenius cihazının kullanımı (p:0.007)'nın kök hücre mobilizasyonunu etkileyen faktörler olduğu görüldü. Çok değişkenli analizlerde ise en önemli faktörlerin tanı (p=0.01), filgrastim kullanımı (p=0.001), fresenius cihazının kullanımı (p=0.03) ve aferezin 1. günündeki lökosit sayısı (p=0.006) olduğu saptandı.

Sonuç: Çalışmamızda tanı, filgrastim ile mobilizasyon, fresenius cihazının kullanılması, ve aferezin 1. gününde periferik kandaki WBC sayısının kök hücre mobilizasyonunu etkileyen en önemli değişkenler olduğu saptanmıştır.

 

Anahtar Kelimeler: Kök hücre mobilizasyonu, Hematopoetik periferal kök hücre nakli, Filgrastim, Lenograstim, Aferez

Keywords

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