Schröder K, Garbe C, Waibel M, Reupke H, Detmar M, Dallenbach F, Orfanos C E
Universitäts-Hautklinik und Poliklinik, Klinikum Steglitz, Freien Universität Berlin.
Hautarzt. 1992 Nov;43(11):700-6.
Three patients with HIV-associated Kaposi sarcoma were treated with human recombinant granulocyte colony stimulating factor (G-CSF). They had all developed leucopenia during treatment with recombinant interferon-alpha-2a, in two cases combined with vincristine. In all three patients, there was an obvious rapid stimulation after s.c. injection of 300 or 150 micrograms G-CSF per day; the white blood count reached normal values within only a few days and partial transformation to leucocytosis took place. After discontinuation of G-CSF, leucocyte counts regressed rapidly to pretreatment levels. A dose of 150 micrograms of G-CSF twice to three times per week proved to be sufficient to keep the white blood cell count in the normal range allowing the treatment necessary for Kaposi sarcoma. G-CSF therapy had no serious side effects. One of the patients developed a tumour-like infiltration in his left upper jaw, which histologically simulated Burkitt's lymphoma and which regressed spontaneously after discontinuation of the G-CSF therapy. G-CSF plays an important role in the treatment of patients with HIV-associated Kaposi sarcoma and enables combined treatment with zidovudine, interferon, and cytostatic drugs.
三名人类免疫缺陷病毒相关卡波西肉瘤患者接受了重组人粒细胞集落刺激因子(G-CSF)治疗。他们在接受重组干扰素-α-2a治疗期间均出现了白细胞减少症,其中两例还联合使用了长春新碱。在所有三名患者中,每天皮下注射300或150微克G-CSF后均出现明显的快速刺激反应;白细胞计数在短短几天内恢复到正常水平,部分患者转变为白细胞增多。停用G-CSF后,白细胞计数迅速降至治疗前水平。事实证明,每周两次至三次、每次150微克的G-CSF剂量足以使白细胞计数维持在正常范围内,从而能够进行卡波西肉瘤所需的治疗。G-CSF治疗无严重副作用。其中一名患者左上颌出现肿瘤样浸润,组织学上类似伯基特淋巴瘤,在停用G-CSF治疗后自发消退。G-CSF在人类免疫缺陷病毒相关卡波西肉瘤患者的治疗中发挥着重要作用,并使齐多夫定、干扰素和细胞毒性药物的联合治疗成为可能。