Vose J M, Bierman P J, Kessinger A, Coccia P F, Anderson J, Oldham F B, Epstein C, Armitage J O
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
Bone Marrow Transplant. 1991 Feb;7(2):139-43.
To test the value of recombinant human granulocyte-macrophage colony stimulating factor for the treatment of delayed engraftment following high dose therapy and autologous hematopoietic stem cell transplantation, we enrolled 12 patients with recurrent non-Hodgkin's lymphoma or Hodgkin's disease having an absolute granulocyte count less than 150 x 10(6)/l on day 30 after autologous hematopoietic stem cell infusion in an open-label, nonrandomized study. These patients were compared to 21 similar historical control patients who were not treated with colony stimulating factor. Overall, the patients treated with granulocyte-macrophage colony stimulating factor had a mean absolute granulocyte count of 704 x 10(6)/l on day 44 after stem cell infusion compared to a mean absolute granulocyte count of 408 x 10(6)/l in historical controls (p = 0.008). The number of documented bacterial and fungal infections occurring after day 30 (9 vs 0, p = 0.01) was significantly reduced in the study group. The toxicity attributed to the granulocyte-macrophage colony stimulating factor was minimal with only one patient experiencing chills. Recombinant human granulocyte-macrophage colony stimulating factor appears to be effective for the treatment of delayed engraftment following high-dose therapy and autologous hematopoietic transplantation for lymphoid malignancies, with most patients having accelerated granulocytic recovery and a reduced incidence of infections.
为了测试重组人粒细胞巨噬细胞集落刺激因子对大剂量治疗及自体造血干细胞移植后植入延迟的治疗价值，我们在一项开放标签、非随机研究中，纳入了12例复发性非霍奇金淋巴瘤或霍奇金病患者，这些患者在自体造血干细胞输注后第30天的绝对粒细胞计数低于150×10⁶/L。将这些患者与21例未接受集落刺激因子治疗的类似历史对照患者进行比较。总体而言，接受粒细胞巨噬细胞集落刺激因子治疗的患者在干细胞输注后第44天的平均绝对粒细胞计数为704×10⁶/L，而历史对照患者的平均绝对粒细胞计数为408×10⁶/L（p = 0.008）。研究组中30天后记录的细菌和真菌感染数量（9例对0例，p = 0.01）显著减少。粒细胞巨噬细胞集落刺激因子所致的毒性极小，只有1例患者出现寒战。重组人粒细胞巨噬细胞集落刺激因子似乎对淋巴恶性肿瘤大剂量治疗及自体造血移植后植入延迟有效，大多数患者粒细胞恢复加速且感染发生率降低。
