Cavallaro A M, Lilleby K, Majolino I, Storb R, Appelbaum F R, Rowley S D, Bensinger W I
Unità Trapianti, Divisione di Ematologia, Ospedale 'V Cervello', Palermo, Italy.
Bone Marrow Transplant. 2000 Jan;25(1):85-9. doi: 10.1038/sj.bmt.1702072.
One hundred and one donors who had received filgrastim (rhG-CSF) for the purpose of donating either granulocytes or peripheral blood stem cells (PBSC) for their relatives more than 3 years ago were contacted. All donors had received daily rhG-CSF at a median dose of 16 microg/kg/day (range 3-16) for a median of 6 days (range 3-15 days). All collection procedures were completed and short-term side-effects of rhG-CSF were mild in the majority of the donors. At a median time interval of 43.13 months (range 35-73), the donors were contacted to assess whether adverse effects related to rhG-CSF administration had occurred. Prior to rhG-CSF two donors had cancer, one had a myocardial infarction, one was hepatitis C virus positive, one had a history of sinusitis, one had Graves' disease and two had arterial hypertension. None worsened with the rhG-CSF administration but the donor with a history of infarction had an episode of angina following apheresis, and the donor with Graves' disease had a stroke 15 months after rhG-CSF. Two pregnancies occurred after the rhG-CSF administration and one donor was 2-3 weeks pregnant during rhG-CSF treatment. Three pregnancies resulted in two normal births and one in a spontaneous abortion of a pregnancy which occurred more than 2 years following rhG-CSF. In the time following rhG-CSF administration two donors developed cancer (breast and prostate cancer) at a follow-up of 70 and 11 months, respectively. One donor developed lymphadenopathy 38 months after the rhG-CSF, which spontaneously resolved. Blood counts were obtained in 70 donors at a median follow up of 40.4 months (range 16.8-70.8). Hematocrit was 43% (median, range 36.8-48), white blood cells were 5.7 x 109/l (median, range 3-14), granulocytes 3.71 x 109/l (median, range 1. 47-10.36), lymphocytes 1.67 x 109/l (median, range 0.90-3.96), monocytes 0.46 x 109/l (median, range 0.07-0.87) and platelet counts were 193.0 x 109/l (median, range 175.0-240.0). This study indicates that short-term administration of rhG-CSF to normal donors for the purpose of mobilizing the PBSC or granulocytes appears safe and without any obvious adverse effects more than 3 years after the donation. Bone Marrow Transplantation (2000) 25, 85-89.
我们联系了101名供者,他们在3年多以前曾接受非格司亭(重组人粒细胞集落刺激因子)以给亲属捐献粒细胞或外周血干细胞(PBSC)。所有供者均接受了每日的重组人粒细胞集落刺激因子,中位剂量为16μg/kg/天(范围3 - 16),中位疗程为6天(范围3 - 15天)。所有采集程序均已完成,大多数供者重组人粒细胞集落刺激因子的短期副作用较轻。在中位时间间隔43.13个月(范围35 - 73)时,联系供者以评估是否发生了与重组人粒细胞集落刺激因子给药相关的不良反应。在使用重组人粒细胞集落刺激因子之前,两名供者患有癌症,一名有心肌梗死,一名丙型肝炎病毒阳性,一名有鼻窦炎病史,一名有格雷夫斯病,两名有动脉高血压。使用重组人粒细胞集落刺激因子后均未恶化,但有梗死病史的供者在单采术后发生了一次心绞痛发作,有格雷夫斯病的供者在使用重组人粒细胞集落刺激因子15个月后发生了中风。使用重组人粒细胞集落刺激因子后发生了两次妊娠,一名供者在重组人粒细胞集落刺激因子治疗期间怀孕2 - 3周。三次妊娠导致两次正常分娩,一次妊娠在使用重组人粒细胞集落刺激因子2年多后自然流产。在使用重组人粒细胞集落刺激因子后的随访期间,两名供者分别在70个月和11个月时发生了癌症(乳腺癌和前列腺癌)。一名供者在使用重组人粒细胞集落刺激因子38个月后出现淋巴结病,后自行缓解。70名供者在中位随访40.4个月(范围16.8 - 70.8)时进行了血细胞计数。血细胞比容为43%(中位值,范围36.8 - 48),白细胞为5.7×10⁹/L(中位值,范围3 - 14),粒细胞为3.71×10⁹/L(中位值,范围1.47 - 10.36),淋巴细胞为1.67×10⁹/L(中位值,范围0.90 - 3.96),单核细胞为0.46×10⁹/L(中位值,范围0.07 - 0.87),血小板计数为193.0×10⁹/L(中位值,范围175.0 - 240.0)。本研究表明,为动员外周血干细胞或粒细胞而对正常供者短期使用重组人粒细胞集落刺激因子在捐献后3年多似乎是安全的,且无任何明显不良反应。《骨髓移植》(2000年)25卷,85 - 89页 。