Egli F, Hofer S, Greminger P, Rhyner K
Departement für Innere Medizin, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1989 Dec 9;119(49):1777-80.
A 60-year-old patient with a myelodysplastic syndrome (MDS) corresponding to refractory anemia with an increase in blast cells (RAEB) was treated with granulocyte-macrophage colony stimulating factor (GM-CSF) and erythropoietin (EPO) for severe symptomatic pancytopenia. During the GM-CSF treatment a distinct increase in granulocytes was observed, but the reticulocytes and thrombocytes decreased to the point where treatment had to be discontinued after eight days. After subsequent treatment with EPO the reticulocyte count rose from 0% to 2%. However, this rise alone was insufficient to decrease the number of blood transfusions required. The thrombocyte count rose to the original values after the cessation of GM-CSF therapy while continuing treatment with EPO. Bone marrow investigations were performed before and after GM-CSF treatment and indicated a distinct increase in the myeloid precursor cells after therapy, without an increase in blasts. On the other hand, an obvious decrease in erythro- and megakaryopoiesis was observed.
一名60岁患有骨髓增生异常综合征（MDS），符合伴有原始细胞增多的难治性贫血（RAEB）的患者，因严重的症状性全血细胞减少，接受了粒细胞巨噬细胞集落刺激因子（GM-CSF）和促红细胞生成素（EPO）治疗。在GM-CSF治疗期间，观察到粒细胞明显增多，但网织红细胞和血小板减少，以至于在八天后不得不停止治疗。在随后接受EPO治疗后，网织红细胞计数从0%升至2%。然而，仅这一升高不足以减少所需的输血次数。在停止GM-CSF治疗并继续EPO治疗后，血小板计数升至原始值。在GM-CSF治疗前后进行了骨髓检查，结果显示治疗后髓系前体细胞明显增多，原始细胞未增加。另一方面，观察到红系和巨核系造血明显减少。
