中文摘要：

目的探讨重组人粒细胞集落刺激因子（rhG—CSF）动员的供者外周血造血干细胞（PBSC）治疗异基因造血干细胞移植术后植入功能不良（PGF）的安全性及有效性。方法对2003年1月至2012年11月期间诊断PGF并接受PBSC治疗的患者进行回顾性分析，观察输注后30d血液学反应及回输后发生移植物抗宿主病（GVHD）的情况。结果28例PGF患者接受了PBSC治疗，其中男21例，女7例。中位年龄28（12～50）岁。16例为原发性PGF，12例为继发性PGF。回输的单个核细胞（MNC）中位数为2．0（1．0～5．8）×10／kg，随访至回输后6个月。28例患者中，12例（42．9％）在回输后30d获得血液学反应，总体有效率为53．6％（15／28）。回输后发生GVHD8例（28．6％）。最终存活16例（57．1％）。患者年龄（≤28岁／〉28岁）、性别、供者类型（同胞相合／亲缘不相合）、PBSC前是否接受预处理、初始中性粒细胞植活时间（≤18d／〉18d）、PBSC植活时间（≤100d／〉100d）及回输MNC数（≤2．0×108／kg／〉2．0×108／kg）对血细胞恢复没有影响。原发性PGF的30d有效率（4／16）明显低于继发性PGF（8／12）（P=0．022）。结论rhG-CSF动员的PBSC治疗可作为继发性PGF的一种治疗方案，但对于原发性PGF疗效欠佳。

英文摘要：

Objective To assess the efficacy and safety of recombinant human granulocyte colony stimulating factor （rhG-CSF） primed donor peripheral blood stem cell （PBSC） on the treatment of poor graft function （PGF） after allogeneic stem cell transplantation （allo-HSCT）. Methods The patients diagnosed as PGF after allo-HSCT and transfused with rhG-CSF primed PBSC from January 2003 to November 2012 were retrospectively analyzed. Hematological response was assessed at day 30 after transfusion. Graft versus host disease （GVHD） was assessed until 6 months after transfusion. Results There were 28 patients including 21 men and 7 women with a median age of 28 （ 12-50 ） years old. Of these patients, 16 were diagnosed as primary PGF. The median number of transfused mononuelear cells was 2. 0 （ 1.0-5.8 ） x 108/kg. Totally 42. 9% （ 12/28 ） patients achieved good response. Eight patients （ 28.6% ） developed GVHD. Sixteen patients （57.1% ） survived. Age （ ~〈/〉 28 years） , gender, donor type （ matched sibling/ mismatched related ） , additional conditioning regimen prior to transfusion, time of neutrophil engraftment （ ~〈/〉 18 days） time of transfusion （ ~〈/〉 100 days after allo-HSCT） and number of mononuelear cells （~〈/〉 2. 0 x 10S/kg） did not impact hematological response. However, response rate of primary PGF （4/16） was significantly lower than that of secondary PGF （8/12） （P = 0. 022）. Conclusion Transfusion of PBSC mobilized by rhG-CSF could be considered as an option to treat secondary PGF after allogeneic stem cell transplantation.