Kojima S, Fukuda M, Miyajima Y, Matsuyama T, Horibe K
Division of Hematology/Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital.
Blood. 1991 Mar 1;77(5):937-41.
Twenty children (aged 1 to 17 years) with severe or moderate aplastic anemia were treated with recombinant human granulocyte colony-stimulating factor (rhG-CSF) at a dose of 400 micrograms/m2 per day administered as a 30-minute intravenous (IV) infusion daily for 2 weeks. This treatment increased the neutrophil counts (2.7- to 28.0-fold) in 12 of the 20 patients. Increasing doses (800 or 1,200 micrograms/m2 per day) were administered to five patients who had not responded to the initial dose, and three showed an increase in neutrophil count. Differential counts of bone marrow (BM) aspirates showed an increase in the myeloid/erythroid ratio. The response was transient, however, and the neutrophil count returned to baseline within 2 to 10 days of discontinuing treatment. No severe toxicity attributable to rhG-CSF was observed. The results suggest that this agent is effective in stimulating granulopoiesis in children with aplastic anemia. Our study also indicates that rhG-CSF will be particularly useful in managing patients with aplastic anemia complicated by bacterial or fungal infection.
20名患有重度或中度再生障碍性贫血的儿童（年龄在1至17岁之间）接受了重组人粒细胞集落刺激因子（rhG-CSF）治疗，剂量为每天400微克/平方米，通过30分钟静脉输注给药，每天一次，共2周。该治疗使20名患者中的12名中性粒细胞计数增加（2.7至28.0倍）。对初始剂量无反应的5名患者接受了增加剂量（每天800或1200微克/平方米）的治疗，其中3名患者中性粒细胞计数增加。骨髓穿刺物的分类计数显示髓系/红系比值增加。然而，反应是短暂的，停药后2至10天内中性粒细胞计数恢复到基线水平。未观察到rhG-CSF引起的严重毒性。结果表明，该药物对刺激再生障碍性贫血儿童的粒细胞生成有效。我们的研究还表明，rhG-CSF在治疗并发细菌或真菌感染的再生障碍性贫血患者时将特别有用。
