Huang Si-Yong, Liu Li, Hao Miao-Wang, Yin Dan-Dan, Wu Yan-Lan, Chen Ren-An, Li Gou-Hui, Lui Qian, Wang Jing-Cheng, He Hua, Liang Ying-Min
Department of Hematology, Fourth Military Medical University, Shaanxi Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2011 Dec;19(6):1415-8.
The purpose of this study was to compare the efficacy of CEP plus G-CSF and CVP plus G-CSF regimens in the mobilization and collection of peripheral blood hematopoietic stem cells (PBHSC), and in the hematopoietic recovery. 57 patients with non-Hodgkin's lymphoma (NHL) underwent autologous PBHSC transplantation were analyzed retrospectively. The PBHSC were mobilized and collected by using CEP plus G-CSF and CVP plus G-CSF respectively, and were retransfused into these NHL patients after preconditioning, then the mobilization efficacy, adverse reactions and hematopoietic recovery were analyzed. The results showed that the WBC count decreased to ≤ 1.0 × 10(9)/L, platelet amount dropped to ≤ 40 × 10(9)/L during peripheral blood stem cell mobilization of all patients, which indicated successful collection of PBHSC. The mean value of (4.38 ± 3.40) × 10(8)/kg mononuclear cells (MNC) containing (2.79 ± 2.53) × 10(6)/kg CD34(+) cells were collected in CEP plus G-CSF group, while the mean value of (3.31 ± 1.23) × 10(8)/kg MNC containing (2.02 ± 0.87) × 10(6)/kg CD34(+) cells were collected in CVP plus G-CSF group. The efficacy of mobilization in CEP plus G-CSF group was significantly higher than that in CVP plus G-CSF group (p < 0.05). After preconditioning, bone marrow was suppressed in all patients. The average time of WBC count recovery to ≥ 1.0 × 10(9)/L was 11.4 days in CEP plus G-CSF group and 12.3 days in CVP plus G-CSF group; the average time of platelet amount recovery to ≥ 50 × 10(9)/L was 18.6 days in CEP plus G-CSF group and 19.3 days in CVP plus G-CSF group. The statistical analysis showed no significant difference in the average time of hematopoietic recovery between 2 groups. It is concluded that autologous PBHSC transplantation shows significant effect for treatment of patients with NHL. Either modified CEP or CVP plus G-CSF regimen is safe and effective in PBHSC mobilization. The CEP plus G-CSF regimen is better than CVP plus G-CSF regimen.
本研究旨在比较CEP加G-CSF方案与CVP加G-CSF方案在外周血造血干细胞（PBHSC）动员采集及造血恢复方面的疗效。对57例行自体PBHSC移植的非霍奇金淋巴瘤（NHL）患者进行回顾性分析。分别采用CEP加G-CSF和CVP加G-CSF动员采集PBHSC，预处理后回输给这些NHL患者，然后分析动员效果、不良反应及造血恢复情况。结果显示，所有患者外周血干细胞动员期间白细胞计数均降至≤1.0×10⁹/L，血小板计数均降至≤40×10⁹/L，表明PBHSC采集成功。CEP加G-CSF组采集的单个核细胞（MNC）均值为（4.38±3.40）×10⁸/kg，其中CD34⁺细胞均值为（2.79±2.53）×10⁶/kg；CVP加G-CSF组采集的MNC均值为（3.31±1.23）×10⁸/kg，其中CD34⁺细胞均值为（2.02±0.87）×10⁶/kg。CEP加G-CSF组的动员效果显著高于CVP加G-CSF组（p<0.05）。预处理后，所有患者骨髓均受抑制。CEP加G-CSF组白细胞计数恢复至≥1.0×10⁹/L的平均时间为11.4天，CVP加G-CSF组为12.3天；CEP加G-CSF组血小板计数恢复至≥50×10⁹/L的平均时间为18.6天，CVP加G-CSF组为19.3天。统计学分析显示两组造血恢复平均时间无显著差异。结论是自体PBHSC移植治疗NHL患者效果显著。改良的CEP或CVP加G-CSF方案在PBHSC动员中安全有效。CEP加G-CSF方案优于CVP加G-CSF方案。
