Demuynck H, Delforge M, Verhoef G, Zachée P, Vandenberghe P, Boogaerts M
Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium.
Br J Haematol. 1995 Jun;90(2):384-92. doi: 10.1111/j.1365-2141.1995.tb05163.x.
Patients suffering from high-risk multiple myeloma (MM) were randomized to receive single high-dose cyclophosphamide followed by either rhGM-CSF or rhG-CSF in order to harvest circulating peripheral blood progenitor cells. The safety of the procedure, the mobilization kinetics, the relative efficacy of rhGM-CSF and rhG-CSF to mobilize progenitor cells and their relative toxicity were studied. Special attention was paid to the antigenic profile of CD34+ progenitor cells. Group I patients (n = 11) were treated with cyclophosphamide 4 g/m2 i.v. followed by rhGM-CSF at 10 micrograms/kg/d by subcutaneous administration. Group II (n = 11) patients received rhG-CSF s.c. at 10 micrograms/kg/d after the same dose cyclophosphamide. Both mobilization regimens appeared to be equally effective. No significant differences in absolute numbers of circulating progenitors, determined by CD34 expression or in yields of MNC, CFU-GM, BFU-E and CD34 subsets were observed. rhGM-CSF administration resulted however in delayed haemopoietic recovery and an increased complication rate. We conclude that rhG-CSF may be preferred because of its markedly lower toxicity and lower in-hospital costs.
患有高危多发性骨髓瘤（MM）的患者被随机分组，先接受单次大剂量环磷酰胺治疗，随后分别接受重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）或重组人粒细胞集落刺激因子（rhG-CSF）治疗，以便采集循环外周血祖细胞。研究了该操作的安全性、动员动力学、rhGM-CSF和rhG-CSF动员祖细胞的相对疗效及其相对毒性。特别关注了CD34+祖细胞的抗原谱。第一组患者（n = 11）接受4 g/m2静脉注射环磷酰胺治疗，随后皮下注射10微克/千克/天的rhGM-CSF。第二组（n = 11）患者在接受相同剂量环磷酰胺治疗后，皮下注射10微克/千克/天的rhG-CSF。两种动员方案似乎同样有效。在通过CD34表达确定的循环祖细胞绝对数量或单核细胞（MNC）、粒-巨噬细胞集落形成单位（CFU-GM）、爆式红系集落形成单位（BFU-E）和CD34亚群产量方面，未观察到显著差异。然而，rhGM-CSF的给药导致造血恢复延迟和并发症发生率增加。我们得出结论，由于rhG-CSF的毒性明显较低且住院费用较低，可能更受青睐。
