Yu Wen-Liang, Hua Zi-Chun
The State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Macao, China.
The State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, China.
Oncotarget. 2018 Jun 15;9(46):28226-28239. doi: 10.18632/oncotarget.24890.
The impact of granulocyte-macrophage colony stimulating factor (GM-CSF) on hematologic indexes and complications remains existing contradictory evidence in cancer patients after treatment of chemotherapy. Eligible studies up to March 2017 were searched and reviewed from PubMed and Wanfang databases. Totally 1043 cancer patients from 15 studies were included in our research. The result indicated that GM-CSF could significantly improve white blood cells count (SMD = 1.16, 95% CI: 0.71 - 1.61, Z = 5.03, < 0.00001) and reduce the time to leukopenia recovery (SMD = -0.85, 95% CI: -1.16 - -0.54, Z = 5.38, < 0.00001) in cancer patients after treatment of chemotherapy. It also could improve absolute neutrophil count (SMD = 1.11, 95% CI: 0.39 - 1.82, Z = 3.04, = 0.002) and significantly shorten the time to neutropenia recovery (SMD = -1.47, 95% CI: -2.20 - -1.75, Z = 3.99, < 0.0001). However, GM-CSF could not improve blood platelet (SMD = 0.46, 95% CI: -0.37 - -1.29, Z = 1.10, = 0.27). And GM-CSF had significant connection with fever (RR = 3.44, 95% CI: 1.43 - 8.28, Z = 2.76, = 0.006). The publication bias existed in the data of the impact of GM-CSF on blood platelet and complication. In conclusions, GM-CSF had an intimate association with some hematologic indexes and complications. Our study suggested that more hematological indexes and even more other indexes need to be observed in future studies.
在癌症患者化疗后，粒细胞巨噬细胞集落刺激因子（GM-CSF）对血液学指标及并发症的影响，目前仍存在相互矛盾的证据。检索并回顾了截至2017年3月来自PubMed和万方数据库的符合条件的研究。我们的研究共纳入了15项研究中的1043例癌症患者。结果表明，GM-CSF可显著提高癌症患者化疗后的白细胞计数（标准化均数差[SMD]=1.16，95%置信区间[CI]：0.71 - 1.61，Z=5.03，P<0.00001），并缩短白细胞减少恢复时间（SMD=-0.85，95%CI：-1.16 - -0.54，Z=5.38，P<0.00001）。它还可提高绝对中性粒细胞计数（SMD=1.11，95%CI：0.39 - 1.82，Z=3.04，P=0.002），并显著缩短中性粒细胞减少恢复时间（SMD=-1.47，95%CI：-2.20 - -1.75，Z=3.99，P<0.0001）。然而，GM-CSF不能提高血小板计数（SMD=0.46，95%CI：-0.37 - -1.29，Z=1.10，P=0.27）。并且GM-CSF与发热有显著关联（相对危险度[RR]=3.44，95%CI：1.43 - 8.28，Z=2.76，P=0.006）。GM-CSF对血小板及并发症影响的数据存在发表偏倚。总之，GM-CSF与一些血液学指标及并发症密切相关。我们的研究表明，未来研究中需要观察更多的血液学指标乃至更多其他指标。
