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单剂量重组人粒细胞集落刺激因子联合化疗在自体外周血干细胞移植中的临床研究

[Clinical study on single-dose rhG-CSF combined with chemotherapy in autologous peripheral blood stem cell transplantation].

作者信息

Tian Hong, Zhou Shu-yun

出版信息

Ai Zheng. 2002 Aug;21(8):896-9.

Abstract

BACKGROUND & OBJECTIVE: This study was designed to evaluate the effectiveness of high-dose chemotherapy plus single daily dose of 250 micrograms/d rhG-CSF(lenograstim) in autologous peripheral blood stem cells mobilization and hematopoietic reconstitution after transplantation.

METHODS

The study included a group of 55 consecutive patients with hematological malignancies (28 cases of acute myelogenous leukemia, 9 cases of acute lymphoblastic leukemia, 14 cases of non-Hodgkin's lymphoma, 4 cases of other disease) from October 1999 to December 2001 undergoing either EA or other intensive chemotherapies as CTX, G-CSF mobilization began from the day when the WBC count reached nadir until the day of apheresis, then after stem cell reinfusion G-CSF support was given on day +3 until neutrophil recovery. The dose of G-CSF both in mobilization and recovery support was 250 micrograms/d s.c. despite the body weight of patients.

RESULTS

The average time of G-CSF administrating as a mobilizing reagent was 7.12 days(range 3-14 days), and the mean time of interval from the beginning of chemotherapy to apheresis was 18.08 +/- 3.63 days. All patients need an average of 1.3 times for apheresis. The median mononuclear cell and CD34+ cell yield were 4.09 x 10(8)/kg and 8.5 x 10(6)/kg, respectively. G-CSF was used after transplantation for a median time of 8 days(range 4-19). All patients achieved an ANC > 0.5 x 10(9)/L after a median of 10.5 days (range 8-26). No severe toxic reaction was observed.

CONCLUSION

We concluded that chemotherapy plus rhG-CSF(lenograstim) given in the single dose fashion can be used in both mobilizing and post transplantation setting with satisfying outcome.

摘要

背景与目的

本研究旨在评估大剂量化疗加每日单次剂量250微克/天的重组人粒细胞集落刺激因子(来格司亭)在自体外周血干细胞动员及移植后造血重建中的有效性。

方法

该研究纳入了1999年10月至2001年12月期间连续的55例血液系统恶性肿瘤患者(急性髓性白血病28例、急性淋巴细胞白血病9例、非霍奇金淋巴瘤14例、其他疾病4例),这些患者接受EA或其他强化化疗如环磷酰胺,当白细胞计数达到最低点之日起开始使用G-CSF动员,直至采集干细胞之日,然后在干细胞回输后第3天给予G-CSF支持,直至中性粒细胞恢复。无论患者体重如何,G-CSF在动员及恢复支持中的剂量均为250微克/天皮下注射。

结果

作为动员剂使用G-CSF的平均时间为7.12天(范围3 - 14天),从化疗开始至采集干细胞期间的平均间隔时间为18.08±3.63天。所有患者平均需要采集1.3次。单个核细胞和CD34+细胞产量的中位数分别为4.09×10⁸/kg和8.5×10⁶/kg。移植后使用G-CSF的中位时间为8天(范围4 - 19天)。所有患者在中位数10.5天(范围8 - 26天)后中性粒细胞绝对值均>0.5×10⁹/L。未观察到严重的毒性反应。

结论

我们得出结论,化疗加单剂量的重组人粒细胞集落刺激因子(来格司亭)可用于动员及移植后阶段,效果令人满意。

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