Marín P, Rovira M, Sanz C, Montserrat E, Rozman C
Escuela Profesional de Hematología Farreras Valenti, Hospital Clínic, Universidad de Barcelona.
Sangre (Barc). 1990 Oct;35(5):397-9.
The treatment of patients with refractory bone marrow aplasia in whom bone marrow transplant cannot be performed is unsatisfactory. Infections and haemorrhages are the most frequent cause of death in such patients. Human recombinant proteins from haemopoietic growth factors provide new therapeutic possibilities. The clinical and biologic course of one such patient treated with rhGM-CSF is reported here. The patient had severe bone marrow aplasia refractory to immunosuppressive treatment, and an improvement of leucocyte, neutrophil and eosinophil counts, along with the healing of an infection only partially controlled with antibiotics, followed the administration of rhGM-CSF. However, such peripheral blood improvement was not accompanied by any increase of bone marrow cellularity, as measured by conventional histopathologic methods, and the patient died due to ictero-ascitic evolution of post-transfusion chronic liver disease.
对于无法进行骨髓移植的难治性骨髓再生障碍患者，其治疗效果并不理想。感染和出血是这类患者最常见的死亡原因。造血生长因子来源的重组蛋白提供了新的治疗可能性。本文报道了一名接受重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）治疗的此类患者的临床及生物学病程。该患者患有严重的骨髓再生障碍，对免疫抑制治疗无效，在给予rhGM-CSF后，白细胞、中性粒细胞和嗜酸性粒细胞计数有所改善，同时仅用抗生素部分控制的感染也得以痊愈。然而，通过传统组织病理学方法检测发现，外周血的这种改善并未伴随骨髓细胞密度的增加，该患者最终因输血后慢性肝病的黄疸腹水进展而死亡。
