Yang Jian-Liang, Shi Yuan-Kai, He Xiao-Hui, Zhou Sheng-Yu, Zhou Ai-Ping, Han Xiao-Hong, Liu Peng, Zhang Chang-Gong, Ai Bin
Department of Medical Oncology, Cancer Institute(Hospital), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, PR China.
Ai Zheng. 2003 Aug;22(8):785-9.
BACKGROUND & OBJECTIVE: High dose chemotherapy and radiotherapy supported by autologous hematopoietic stem cells transplantation(AHSCT) can improve the efficacy of some malignant solid tumors. Successful AHSCT should owe to rational usage of recombinant human granulocyte colony-stimulating factor (rhG-CSF) in some extent. The purpose of this study was to observe the role of rhG-CSF in hematological recovery after AHSCT for patients with solid tumors.
A total of 130 patients with solid tumors were divided into two groups. The rhG-CSF group received rhG-CSF at the dose of 250-300 microg daily from day 6 until WBC recovering to 5.0 x 10(9)/L. The control group did not receive rhG-CSF after AHSCT.
A total of 132 person-times AHSCT were finished and 2 patients of them experienced twice transplantation. Twenty-four patients received autologous bone marrow transplantation (ABMT), 12 of them received rhG-CSF following AHSCT and the others did not. One hundred and six persons underwent autologous peripheral blood stem cells transplantation (APBSCT), 47 patients received rhG-CSF and 61 did not. (1)In rhG-CSF group and control group of ABMT,the median days of WBC up to 5.0 x 10(9)/L were 14 days and 24 days (P< 0.001),respectively. The median time of hospitalization was 33 days and 41 days (P< 0.05),respectively. There was no statistical difference in median time of PLT recovering to 20 x 10(9)/L and 50 x 10(9)/L in the two groups.(2)In rhG-CSF group and control group of APBSCT,the median time of WBC recovering to 5.0 x 10(9)/L were 10 days and 13 days (P< 0.01), respectively. The median time of hospitalization was 17 days and 20 days(P< 0.01),respectively. There was no significantly statistical difference in median time of PLT recovering to 50 x 10(9)/L in the two groups. (3)The frequency of infectious complication was no statistical difference between two groups (P=0.45).
rhG-CSF administration after AHSCT can obviously accelerate the recovery of WBC and shorten the time of hospitalization, but there is no significant effect on the recovery of PLT. Further study is needed to investigate whether rhG-CSF can reduce the infectious complication.
自体造血干细胞移植（AHSCT）支持下的大剂量化疗和放疗可提高某些恶性实体瘤的疗效。成功的AHSCT在一定程度上应归功于重组人粒细胞集落刺激因子（rhG-CSF）的合理使用。本研究旨在观察rhG-CSF在实体瘤患者AHSCT后血液学恢复中的作用。
130例实体瘤患者分为两组。rhG-CSF组从第6天开始每日接受250 - 300μg的rhG-CSF，直至白细胞恢复至5.0×10⁹/L。对照组在AHSCT后不接受rhG-CSF。
共完成132人次AHSCT，其中2例患者接受了两次移植。24例患者接受了自体骨髓移植（ABMT），其中12例在AHSCT后接受了rhG-CSF，其余未接受。106例患者接受了自体外周血干细胞移植（APBSCT），47例接受rhG-CSF，61例未接受。（1）ABMT的rhG-CSF组和对照组中，白细胞升至5.0×10⁹/L的中位天数分别为14天和24天（P<0.001）。中位住院时间分别为33天和41天（P<0.05）。两组血小板恢复至20×10⁹/L和50×10⁹/L的中位时间无统计学差异。（2）APBSCT的rhG-CSF组和对照组中，白细胞恢复至5.0×10⁹/L的中位时间分别为10天和13天（P<0.01）。中位住院时间分别为17天和20天（P<0.01）。两组血小板恢复至50×10⁹/L的中位时间无显著统计学差异。（3）两组感染并发症的发生率无统计学差异（P = 0.45）。
AHSCT后给予rhG-CSF可明显加速白细胞恢复并缩短住院时间，但对血小板恢复无显著影响。是否能降低感染并发症尚需进一步研究。
