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重组人粒细胞集落刺激因子(非格司亭)用于霍奇金病和非霍奇金淋巴瘤患者自体骨髓移植的随机、对照、多中心研究结果

Results of a randomised, controlled, multicentre study of recombinant human granulocyte colony-stimulating factor (filgrastim) in patients with Hodgkin's disease and non-Hodgkin's lymphoma undergoing autologous bone marrow transplantation.

作者信息

Schmitz N, Dreger P, Zander A R, Ehninger G, Wandt H, Fauser A A, Kolb H J, Zumsprekel A, Martin A, Hecht T

机构信息

Department of Internal Medicine II, University of Kiel, Germany.

出版信息

Bone Marrow Transplant. 1995 Feb;15(2):261-6.

PMID:7539668
Abstract

In 54 patients with malignant lymphoma, haematopoietic recovery after high-dose chemotherapy and autologous bone marrow transplantation (BMT) was compared between patients randomised to receive 10 or 30 micrograms/kg/day of r-metHuG-CSF (filgrastim) or no growth factor. After standard high-dose chemotherapy with cyclophosphamide, etoposide and BCNU (CVB regimen for patients with Hodgkin's disease) or BCNU, etoposide, cytosine arabinoside and melphalan (BEAM regimen for patients suffering from non-Hodgkin's lymphoma) followed by autologous BMT, r-metHuG-CSF was administered by continuous intravenous infusion from the first day after autologous BMT until neutrophil recovery. When the r-metHuG-CSF groups were compared with the control group the major findings were: the median time to reach an absolute neutrophil count (ANC) > or = 0.5 x 10(9)/L was 20 days in the control group and 12 and 14 days, respectively, in the r-metHuG-CSF groups (P = 0.0004). The duration of neutropenia (ANC < 0.5 x 10(9)/L) was reduced from 27 days in the control group to 11 and 13 days in the r-metHuG-CSF groups (P = 0.0001). In addition, fewer days of febrile neutropenia were observed in the r-metHuG-CSF groups (5 and 6 days) than in the control group (10 days; P = 0.036). No significant effects of r-metHuG-CSF administration on the number of days with fever, the use of intravenous antibiotics and hospitalisation were detected. R-metHuG-CSF was well tolerated without any serious side-effects.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在54例恶性淋巴瘤患者中,对随机接受10或30微克/千克/天的重组人粒细胞集落刺激因子(r-metHuG-CSF,非格司亭)或不接受生长因子的患者进行了大剂量化疗和自体骨髓移植(BMT)后的造血恢复情况比较。在采用环磷酰胺、依托泊苷和卡莫司汀(霍奇金病患者用CVB方案)或卡莫司汀、依托泊苷、阿糖胞苷和美法仑(非霍奇金淋巴瘤患者用BEAM方案)进行标准大剂量化疗后进行自体BMT,从自体BMT后的第一天开始通过持续静脉输注给予r-metHuG-CSF,直至中性粒细胞恢复。将r-metHuG-CSF组与对照组比较,主要发现如下:对照组达到绝对中性粒细胞计数(ANC)≥0.5×10⁹/L的中位时间为20天,r-metHuG-CSF组分别为12天和14天(P = 0.0004)。中性粒细胞减少(ANC<0.5×10⁹/L)的持续时间从对照组的27天减少至r-metHuG-CSF组的11天和13天(P = 0.0001)。此外,r-metHuG-CSF组观察到的发热性中性粒细胞减少天数(5天和6天)少于对照组(10天;P = 0.036)。未检测到r-metHuG-CSF给药对发热天数、静脉使用抗生素和住院时间有显著影响。r-metHuG-CSF耐受性良好,无任何严重副作用。(摘要截短于250字)

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