Pigaditou A, Marini G, Johnson P W, Mahmoud M, Okukenu E, Adams K, Salam A, Amess J A, Norton A J, Murphy M F
ICRF Department of Medical Oncology, St. Bartholomew's Hospital, London, U.K.
Ann Oncol. 1995 Jan;6(1):53-8. doi: 10.1093/oxfordjournals.annonc.a059042.
Myelo-ablative therapy with peripheral blood progenitor cell (PBPC) support is increasingly being used in patients with haematological malignancy considered to be at high risk for recurrence. The results of this approach, in comparison with the previous experience at St. Bartholomew's Hospital (SBH) using autologous bone marrow transplantation form the basis of this report.
42 patients (age range 18-63 years, median 42 years), deemed to have a poor prognosis with conventional therapy received myelo-ablative therapy with PBPC support. Diagnoses comprised: non-Hodgkin's lymphoma (NHL): 16 patients, Hodgkin's disease (HD): 9, Multiple Myeloma (MM): 12, and solid tumours (ST): 5. PBPC were mobilised using adriamycin: 35 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 orally, days 1-5, followed by G-CSF: 5 micrograms/kg, subcutaneously, for a median of 7 days (range 6-9 days).
A total of 67 PBPC collections were performed, 1 being 'sufficient' (i.e. mononuclear cells > or = 1.5 x 10(8)/kg and CD34+ cells > or = 1 x 10(6)/kg) in 21 of the 42 patients. The median time to haematological recovery following reinfusion of PBPC was 13 days for both neutrophils > 0.5 x 10(9)/l and platelets > 20 x 10(9)/l (ranges: 8-27, and 8-48 days, respectively) which is significantly shorter than for patients in the historical control group. Supportive care requirements were also significantly reduced, as was the duration of hospital stay i.e., median 19 days (range 12-73 days) compared with 29 days (range 9-180 days).
These results confirm rapid blood count recovery following myelo-ablative therapy with PBPC support and the feasibility of this approach.
采用外周血祖细胞（PBPC）支持的清髓性疗法越来越多地应用于被认为复发风险高的血液系统恶性肿瘤患者。与圣巴塞洛缪医院（SBH）此前使用自体骨髓移植的经验相比，该方法的结果构成了本报告的基础。
42例患者（年龄范围18 - 63岁，中位年龄42岁），被认为采用传统疗法预后较差，接受了PBPC支持的清髓性疗法。诊断包括：非霍奇金淋巴瘤（NHL）：16例患者，霍奇金病（HD）：9例，多发性骨髓瘤（MM）：12例，实体瘤（ST）：5例。PBPC采用阿霉素动员：第1天静脉注射35 mg/m²，第1 - 5天口服依托泊苷100 mg/m²，随后皮下注射粒细胞集落刺激因子（G - CSF）：5微克/千克，中位时间为7天（范围6 - 9天）。
共进行了67次PBPC采集，42例患者中有21例的1次采集“足够”（即单个核细胞≥1.5×10⁸/kg且CD34⁺细胞≥1×10⁶/kg）。PBPC回输后中性粒细胞>0.5×10⁹/l和血小板>20×10⁹/l的血液学恢复中位时间均为13天（范围分别为8 - 27天和8 - 48天），这明显短于历史对照组患者。支持性护理需求也显著减少，住院时间中位数也减少，即中位19天（范围12 - 73天），而之前为29天（范围9 - 180天）。
这些结果证实了PBPC支持的清髓性疗法后血细胞计数快速恢复以及该方法的可行性。
