Hiura M, Murakami J, Shigemasa K, Fujioka T, Yokoyama T, Nogawa T, Chiba T, Shimokawa T
Department of Gynecology and Clinical Research, National Shikoku Cancer Center, Matsuyama.
Nihon Sanka Fujinka Gakkai Zasshi. 1995 Mar;47(3):257-63.
A new therapeutic strategy for advanced ovarian cancer is to administer ultra-high doses of anticancerous drugs, followed by peripheral blood stem cell transplantation (PBSCT) to recover normal marrow functions. There are, however, no clear regimens to induce mobilization of peripheral blood stem cells (PBSCs). We therefore used three different chemotherapies and granulocyte colony-stimulating factor (G-CSF) to produce a rebound increase in PBSCs during myelosuppression by apheresis. Eleven patients with advanced ovarian cancer (FIGO Stage; IIc-1, IIIc-5, IV-4, Recurrence-1) received chemotherapy with CEP (cyclophosphamide: 500-750mg/m2, epirubicin: 50-70mg/m2, cisplatin: 70mg/m2), CEE (cyclophosphamide: 2,000mg/m2, epirubicin: 50mg/m2, etoposide: 300mg/m2, and PEC salvage (cisplatin: 75mg/m2, etoposide: 300mg/m2, cyclophosphamide: 1,000mg/m2) followed by lenograstim (G-CSF; 2 micrograms/kg subcutaneous injection daily for 14-18 days) to mobilize PBSCs. A range of 0-38.2 x 10(4) (mean +/- S.D.; 11.1 +/- 5.0 x 10(4) colony forming unit granulocyte-macrophage (CFU-GM)/kg in the CEP regimen (n = 15), 1.6-40.8 x 10(4) (mean +/- S.D.; 12.3 +/- 3.6 x 10(4) CFU-GM/kg in the CEE regimen (n = 11), and 8.6-11.4 x 10(4) (mean +/- S.D.; 10.0 +/- 2.0 x 10(4) CFU-GM/kg in the PEC salvage regimen (n = 2) were recruited by a single apheresis. Although the CEE regimen to mobilize PBSCs was much more efficient than the CEP regimen, a large number of PBSCs showing 38.2 x 10(4) CFU-GM/kg were mobilized by the CEP regimen with a dose-escalation of cyclophosphamide 750mg/m2 and epirubicin 70mg/m2. The number of CFU-GM/kg correlated well with that of CD34+ (r = 0.693).(ABSTRACT TRUNCATED AT 250 WORDS)
晚期卵巢癌的一种新治疗策略是给予超高剂量的抗癌药物，随后进行外周血干细胞移植（PBSCT）以恢复正常骨髓功能。然而，目前尚无明确的方案可诱导外周血干细胞（PBSCs）动员。因此，我们使用三种不同的化疗方法和粒细胞集落刺激因子（G-CSF），在骨髓抑制期间通过单采术使PBSCs出现反弹增加。11例晚期卵巢癌患者（国际妇产科联盟分期；IIc-1期1例、IIIc-5期5例、IV期4例、复发1例）接受了CEP方案化疗（环磷酰胺：500 - 750mg/m²、表柔比星：50 - 70mg/m²、顺铂：70mg/m²）、CEE方案化疗（环磷酰胺：2000mg/m²、表柔比星：50mg/m²、依托泊苷：300mg/m²）以及PEC挽救方案化疗（顺铂：75mg/m²、依托泊苷：300mg/m²、环磷酰胺：1000mg/m²），随后使用来格司亭（G-CSF；2微克/千克皮下注射，每日1次，共14 - 18天）来动员PBSCs。通过单次单采术采集到的PBSCs数量在CEP方案组（n = 15）为0 - 38.2×10⁴（均值±标准差；11.1±5.0×10⁴集落形成单位粒细胞 - 巨噬细胞（CFU - GM）/千克），CEE方案组（n = 11）为1.6 - 40.8×10⁴（均值±标准差；12.3±3.6×10⁴CFU - GM/千克），PEC挽救方案组（n = 2）为8.6 - 11.4×10⁴（均值±标准差；10.0±2.0×10⁴CFU - GM/千克）。尽管CEE方案动员PBSCs的效率远高于CEP方案，但在环磷酰胺剂量增至750mg/m²和表柔比星剂量增至70mg/m²的CEP方案中，也动员出了大量PBSCs，达到38.2×10⁴CFU - GM/千克。CFU - GM/千克数量与CD34⁺数量具有良好的相关性（r = 0.693）。（摘要截断于250字）
