Im T, Yamane T, Mugitani A, Hiyoshi M, Park K, Tatsumi N
Department of Hematology, Osaka City Medical School, Japan.
Int J Hematol. 1994 Oct;60(3):215-23.
Twenty-one patients with myelodysplastic syndrome (MDS) or overt leukemia resulting from MDS were treated with recombinant human granulocyte colony-stimulating factor (rhG-CSF) and cytosine arabinoside (Ara-C). Ara-C was administered in a dose of 20 mg/m2 every 12 h for 5 days and after 2 days 125 micrograms of rhG-CSF was administered for 10 days. After recovery of the leukocyte count the therapy was repeated, doubling the dose of Ara-C serially when possible. Of 13 patients with MDS, four achieved complete remission (CR), two good response (GR), two minor response (MR), and five no response (NR). Of eight patients with overt leukemia from MDS, only one with hyperplastic bone marrow achieved a partial response (PR) and the remaining seven achieved NR. The efficacy of the combination of rhG-CSF and Ara-C in the treatment of MDS and its leukemic phase is discussed, including at which time rhG-CSF should be administered: before, after or concomitantly with Ara-C. Multicenter randomized studies are needed in the evaluation of this combination therapy.
21例骨髓增生异常综合征（MDS）或由MDS导致的明显白血病患者接受了重组人粒细胞集落刺激因子（rhG-CSF）和阿糖胞苷（Ara-C）治疗。阿糖胞苷以20mg/m²的剂量每12小时给药1次，共5天，2天后给予125μg的rhG-CSF，持续10天。白细胞计数恢复后重复该治疗，尽可能依次将阿糖胞苷的剂量加倍。13例MDS患者中，4例达到完全缓解（CR），2例有良好反应（GR），2例有微小反应（MR），5例无反应（NR）。8例由MDS导致的明显白血病患者中，仅1例骨髓增生的患者达到部分缓解（PR），其余7例无反应。讨论了rhG-CSF与阿糖胞苷联合治疗MDS及其白血病期的疗效，包括rhG-CSF应在何时给药：在阿糖胞苷之前、之后还是与之同时给药。评估这种联合治疗需要进行多中心随机研究。
