Jakubowski A, Winton E F, Gencarelli A, Gabrilove J
Department of Medicine and Nursing, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Am J Hematol. 1995 Dec;50(4):288-91. doi: 10.1002/ajh.2830500411.
A patient with neutropenia and life-threatening infections secondary to T-gamma lymphoproliferative disease, who did not respond to treatment with recombinant human G-CSF (filgrastim), was treated with filgrastin plus cyclosporine A (CyA). The patient achieved a good response in the absolute neutrophil count and subsequently required a dose reduction in the filgrastim. The patient was eventually discontinued from the CyA but continues on filgrastim alone. While on therapy, the large granular lymphocytes disappeared from the circulation and the beta-TCR rearrangement, which was present prior to beginning therapy, became undetectable. The patient had no significant toxicity to the CyA or the filgrastim and he has not experienced any serious infections or required hospitalization. Filgrastim has proven to be relatively nontoxic and of some benefit to patients with this disease and should probably be utilized first when treatment is necessary. However, if improvement is not observed, these findings suggest that a trial of the combination of CyA plus filgrastim may be beneficial.
一名患有中性粒细胞减少症且因T-γ淋巴细胞增殖性疾病继发危及生命感染的患者，对重组人粒细胞集落刺激因子（非格司亭）治疗无反应，接受了非格司亭加环孢素A（CyA）治疗。患者的绝对中性粒细胞计数获得良好反应，随后需要减少非格司亭的剂量。患者最终停用了环孢素A，但继续单独使用非格司亭。在治疗期间，循环中的大颗粒淋巴细胞消失，治疗开始前存在的β-TCR重排变得无法检测到。患者对环孢素A或非格司亭无明显毒性，未经历任何严重感染或需要住院治疗。非格司亭已被证明相对无毒，对患有这种疾病的患者有一定益处，在必要治疗时可能应首先使用。然而，如果未观察到改善，这些发现表明环孢素A加非格司亭联合治疗试验可能有益。
