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[在自体造血干细胞移植化疗后适当时间使用粒细胞集落刺激因子(G-CSF)可显著提高移植物中CD34(+)细胞的产量]

[Yield of CD34(+) cells in graft can be increased significantly by G-CSF used at appropriate time after chemotherapy for AutoPBSCT].

作者信息

Xu Li, Chang Chun-Kang, Gan Wei-Jin, Su Ji-Ying, Zhang Xi, Wu Lin-Yun, Song Lu-Xi, He Qi, Zhou Li-Yu, Xiao Chao, Liu Hong, Li Xiao

机构信息

Department of Hematology, Shanghai Jiaotong University Sixth Hospital, Shanghai 200233, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2011 Jun;19(3):759-63.

Abstract

This study was aimed to investigate the influence of timing using G-CSF after chemotherapy on graft yield of mobilized peripheral blood stem cells for autoPBSCT. 39 patients with lymphoma or multiple myeloma (MM) received the same chemotherapy mobilization regimen, including CTX 400 mg/m² d1; VLB 2 mg/m(2) d1; Ara-C 60 mg/m ²× d1-5; VP-16 60 mg/m² × d1-5; and prednisone 40 mg/m² × d1-5. The historical control group (12 cases) received G-CSF subcutaneously (filgrastim) at the first restoration after the initial nadir of the peripheral WBC count. The experimental group (27 cases) received G-CSF during the steady rise of the WBC count (end of fluctuating after initial nadir). G-CSF was given in a single daily subcutaneous dose of 5 µg/kg until the final PBSC apheresis. When the peripheral WBC and mononuclear cell (MNC) counts reached 10 × 10⁹/L and 1.0 × 10⁹/L respectively, leukapheresis was carried out using the COBE Spectra blood cell separator. The results indicated that despite there was comparable treatment with alkylating agents between 2 groups, a significantly increased yield of CD34 positive cells was observed in the experimental group (26.4 × 10⁶/kg), as compared to the historical control group (3.1 × 10⁶/kg) (p = 0.0031). It is concluded that the appropriate timing for the use G-CSF mobilization after chemotherapy is important to increase the CD34(+) cell yield in auto-graft.

摘要

本研究旨在探讨化疗后使用粒细胞集落刺激因子(G-CSF)的时机对自体外周血干细胞移植中动员外周血干细胞采集量的影响。39例淋巴瘤或多发性骨髓瘤(MM)患者接受相同的化疗动员方案,包括环磷酰胺(CTX)400mg/m² d1;长春碱(VLB)2mg/m² d1;阿糖胞苷(Ara-C)60mg/m²×d1 - 5;依托泊苷(VP - 16)60mg/m²×d1 - 5;泼尼松40mg/m²×d1 - 5。历史对照组(12例)在首次外周血白细胞计数最低点恢复后皮下注射G-CSF(非格司亭)。实验组(27例)在白细胞计数稳定上升时(首次最低点波动结束后)给予G-CSF。G-CSF每日皮下单次剂量为5μg/kg,直至最终进行外周血干细胞采集。当外周血白细胞和单个核细胞(MNC)计数分别达到10×10⁹/L和1.0×10⁹/L时,使用COBE Spectra血细胞分离机进行白细胞单采。结果表明,尽管两组间烷化剂治疗相当,但与历史对照组(3.1×10⁶/kg)相比,实验组(26.4×10⁶/kg)CD34阳性细胞产量显著增加(p = 0.0031)。结论是化疗后使用G-CSF动员的合适时机对于提高自体移植中CD34(+)细胞产量很重要。

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