Rosenfeld C S, Shadduck R K, Zeigler Z R, Andrews F, Nemunaitis J
Western Pennsylvania Hospital, Western Pennsylvania Cancer Institute, Pittsburgh, USA.
Bone Marrow Transplant. 1995 Mar;15(3):433-8.
Mobilization of peripheral blood stem cells (PBSC) can be accomplished with cytokines or rebound from myelo-suppressive chemotherapy. In this study, patients were mobilized with cyclophosphamide (CY) 4 g/m2 either alone or followed by GM-CSF 250 micrograms/m2 or G-CSF 600 micrograms. Colony-stimulating factors were administered subcutaneously. Eligibility included patients with non-Hodgkin's lymphoma (NHL; n = 29), Hodgkin's disease (n 4) and acute lymphoblastic leukemia (n = 2). One patient died from mobilization-related complications. Admission for neutropenic fevers and other complications occurred in 73% of patients receiving CY alone compared with 32% received CY + G-CSF or GM-CSF (P < 0.05). Apheresis was initiated when the white blood count approached 1 x 10(9)/l and continued until approximately 6 x 10(8) mononuclear cells/kg were collected. Mobilization with CY + GM-CSF led to significantly greater numbers of collected CFU-GM than with CY alone. Colony-stimulating factors were not administered after transplantation. collected progenitor cells correlated with the peak cell counts after mobilization. Following transplantation, an ANC > = 500 x 10(6)/l was achieved at 14.5 days and a platelet count > = 50 x 10(6)/l was achieved on day 20. Days to achieve an ANC > = 500 x 10(6)/l did not correlate with any of the analyzed variables. Platelet engraftment correlated with harvested BFU-E, thawed CD34+ cells and peak counts following mobilization. for patients with NHL, CR was obtained in 82% of evaluable cases. Median time to relapse was 343 days. Twenty five per cent of patients remain disease-free at 900+ days of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
外周血干细胞（PBSC）的动员可通过细胞因子或骨髓抑制性化疗后的恢复来实现。在本研究中，患者接受4 g/m²的环磷酰胺（CY）单独治疗，或之后接受250微克/m²的粒细胞巨噬细胞集落刺激因子（GM-CSF）或600微克的粒细胞集落刺激因子（G-CSF）进行动员。集落刺激因子通过皮下注射给药。符合条件的患者包括非霍奇金淋巴瘤（NHL；n = 29）、霍奇金病（n = 4）和急性淋巴细胞白血病（n = 2）患者。1例患者死于动员相关并发症。单独接受CY治疗的患者中，73%因中性粒细胞减少性发热和其他并发症入院，而接受CY + G-CSF或GM-CSF治疗的患者中这一比例为32%（P < 0.05）。当白细胞计数接近1×10⁹/l时开始进行单采，并持续进行直至收集到约6×10⁸个单核细胞/kg。与单独使用CY相比，CY + GM-CSF动员导致收集到的粒-巨噬细胞集落形成单位（CFU-GM）数量显著更多。移植后未给予集落刺激因子。收集的祖细胞与动员后的峰值细胞计数相关。移植后，在第14.5天达到绝对中性粒细胞计数（ANC）≥500×10⁶/l，在第20天达到血小板计数≥50×10⁶/l。达到ANC≥500×10⁶/l的天数与任何分析变量均无相关性。血小板植入与收获的爆式红系集落形成单位（BFU-E）、解冻的CD34⁺细胞以及动员后的峰值计数相关。对于NHL患者，82%的可评估病例获得完全缓解（CR）。复发的中位时间为343天。在900多天的随访中，25%的患者仍无疾病。（摘要截断于250字）
