Yao Hisayuki, Ashihara Eishi, Maekawa Taira
Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital.
Nihon Rinsho. 2009 Oct;67(10):1951-7.
Bone marrow suppression after intensive chemotherapies in patients with myeloid leukemia is severe, resulting in the reduction of the number of white blood cells, red blood cells, and platelets. Supportive therapies are indispensable for the management of these leukemia patients. The improvement of blood cell transfusion can decrease side effects of chemotherapies and establish the safety. But we still have notable side effects of transfusion such as TRALI (transfusion-related acute lung injury), platelet immunologic refractory state, and so on. Cytokine therapy especially with G-CSF (granulocyte colony-stimulating factor) administration, changed the treatment of myeloid leukemia. G-CSF can shorten the duration of neutropenia and decrease the risk of infection. Recently the effects of Epo (erythropoietin) on chemotherapy-induced anemia have been demonstrated. We discuss here the indications of blood cell transfusion and cytokine therapies in the treatment for myeloid leukemia.
髓系白血病患者接受强化化疗后骨髓抑制严重，导致白细胞、红细胞和血小板数量减少。支持性治疗对于这些白血病患者的管理不可或缺。改善血细胞输注可减少化疗的副作用并确保安全性。但我们仍有显著的输血副作用，如输血相关急性肺损伤（TRALI）、血小板免疫难治状态等。细胞因子治疗，尤其是给予粒细胞集落刺激因子（G-CSF），改变了髓系白血病的治疗方式。G-CSF可缩短中性粒细胞减少的持续时间并降低感染风险。最近，促红细胞生成素（Epo）对化疗所致贫血的作用已得到证实。我们在此讨论血细胞输注和细胞因子治疗在髓系白血病治疗中的适应证。
