Vadhan-Raj S, Velasquez W S, Butler J J, LeMaistre A, Lepe-Zuniga J, Keating M J, Koller C A, Gutterman J U
Department of Clinical Immunology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Am J Hematol. 1990 Mar;33(3):189-97. doi: 10.1002/ajh.2830330307.
In an attempt to stimulate granulopoiesis, we administered recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) to 11 patients with lymphoproliferative disorders. Ten patients had neutropenia, six of whom had severe neutropenia (less than 500 neutrophils), including two with agranulocytosis. GM-CSF (60-250 micrograms/m2/day) was administered by continuous intravenous infusion daily for 14 days at 2-week intervals. Significant increases in white blood cell counts (1.3-to 11.7-fold) and neutrophils (1.7- to more than 29-fold) were seen in 10 of 11 patients, including one patient with agranulocytosis. Eosinophils (3.9- to greater than 65-fold) and monocytes (1.3- to 5-fold) increased as well. In contrast, no significant increases were seen in total lymphocytes or in different phenotypic subsets of lymphocytes during treatment. The overall proportion of myeloid and lymphoid elements in bone marrow remained stable. These results indicate that GM-CSF is effective in stimulating myelopoiesis in neutropenic states associated with lymphoproliferative disorders. Further studies will be necessary to determine whether the correction of neutropenia ultimately translates into clinical benefit.
为了刺激粒细胞生成，我们对11例淋巴增生性疾病患者给予重组人粒细胞-巨噬细胞集落刺激因子（GM-CSF）。10例患者存在中性粒细胞减少，其中6例有严重中性粒细胞减少（中性粒细胞少于500个），包括2例粒细胞缺乏症患者。GM-CSF（60 - 250微克/平方米/天）通过持续静脉输注，每天给药，共14天，间隔2周。11例患者中有10例白细胞计数（增加1.3至11.7倍）和中性粒细胞（增加1.7至超过29倍）显著增加，其中包括1例粒细胞缺乏症患者。嗜酸性粒细胞（增加3.9至超过65倍）和单核细胞（增加1.3至5倍）也有所增加。相比之下，治疗期间总淋巴细胞或淋巴细胞不同表型亚群未见显著增加。骨髓中髓系和淋巴系成分的总体比例保持稳定。这些结果表明，GM-CSF在刺激与淋巴增生性疾病相关的中性粒细胞减少状态下的骨髓生成方面是有效的。需要进一步研究以确定中性粒细胞减少的纠正最终是否能转化为临床益处。
