Ohler L, Scholten C, Reiter E, Tiefengraber E, Jäger U, Strobl H, Lechner K, Höcker P, Geissler K
Abteilung für Hämatologie und Hämostaseologie, Universitätsklinik für Innere Medizin I, Wien.
Wien Klin Wochenschr. 1993;105(20):580-4.
Due to the relatively low tumour cell contamination of peripheral blood in patients with multiple myeloma, autologous transplantation of circulating stem cells may have theoretical advantages over autologous bone marrow transplantation. In four patients with multiple myeloma who where considered potential candidates for autologous stem cell transplantation G-CSF (600 micrograms/day) was administered following chemotherapy in order to maximally increase the number of circulating progenitor cells during haematopoietic rebound and to facilitate progenitor cell harvest by leukapheresis. In two previously untreated patients the administration of G-CSF following chemotherapy according to the UVA protocol (ultralan, vincristine, adriamycin) greatly increased circulating haematopoietic stem cells from 247 to 7552 CFU-GM/ml in patient 1 and from 173 to 6361 CFU-GM/ml in patient 2, which by far exceeded the increase in progenitor cells following chemotherapy alone, namely only to 594 and 317 CFU-GM/ml in patient 1 and patient 2, respectively. In two repeatedly pretreated patients, the combination of UVA and G-CSF was much less effective. Progenitor cells increased from 144 to 735 CFU-GM/ml in patient 3 and only from 222 to 232 CFU-GM/ml in patient 4. In both cases, however, mobilization of haematopoietic progenitor cells by G-CSF following cyclophosphamide (50 and 70 mg/kg body weight, respectively) led to much higher CFU-GM peak values (5324 in patient 3 and 2245 in patient 4), thus allowing an adequate harvest of mononuclear cells and CD 34+ cell numbers to achieve, in all probability, the prompt and complete reconstitution of haematopoiesis in case of transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)
由于多发性骨髓瘤患者外周血中肿瘤细胞污染相对较低，循环干细胞自体移植在理论上可能比自体骨髓移植更具优势。在4例被认为是自体干细胞移植潜在候选者的多发性骨髓瘤患者中，化疗后给予粒细胞集落刺激因子（G-CSF，600微克/天），以便在造血恢复期间最大程度地增加循环祖细胞数量，并通过白细胞分离术促进祖细胞采集。在2例先前未接受过治疗的患者中，按照UVA方案（优保津、长春新碱、阿霉素）化疗后给予G-CSF，使患者1的循环造血干细胞从247 CFU-GM/毫升大幅增加至7552 CFU-GM/毫升，患者2从173 CFU-GM/毫升增加至6361 CFU-GM/毫升，远远超过单纯化疗后祖细胞的增加量，患者1和患者2分别仅增至594 CFU-GM/毫升和317 CFU-GM/毫升。在2例多次接受预处理的患者中，UVA与G-CSF联合使用的效果要差得多。患者3的祖细胞从144 CFU-GM/毫升增至735 CFU-GM/毫升，患者4仅从222 CFU-GM/毫升增至232 CFU-GM/毫升。然而，在这两种情况下，环磷酰胺（分别为50和70毫克/千克体重）后给予G-CSF动员造血祖细胞均导致更高的CFU-GM峰值（患者3为5324，患者4为2245），从而能够充分采集单核细胞和CD 34+细胞数量，很可能在移植后实现造血的迅速和完全重建。（摘要截选至250词）
