Dreger P, Grelle K, Eckstein V, Suttorp M, Müller-Ruchholtz W, Löffler H, Schmitz N
Second Department of Medicine, University of Kiel, Germany.
Br J Haematol. 1993 Jan;83(1):7-13. doi: 10.1111/j.1365-2141.1993.tb04623.x.
The serum levels of soluble interleukin 2 receptors (sIL-2R) were determined in 19 patients who received high-dose chemotherapy and an autologous or syngeneic bone marrow transplant (BMT) for treatment of Hodgkin's disease (n = 18) or non-Hodgkin's lymphoma (n = 1). Twelve patients received granulocyte colony-stimulating factor (G-CSF) from day 0 or day +1 after autologous BMT until the white blood cell count had been stable for 9 d above 1 x 10(9)/l, the remaining seven patients did not receive growth factors. In all G-CSF-treated patients the sIL-2R levels increased steadily in the early post-transplant course, even in the absence of infection. This increase was statistically significant 2-4 d prior to the appearance of leucocytes in the peripheral blood (median 340 pM versus median 256 pM immediately after BMT, P < 0.025) and peaked with the appearance of first peripheral blood leucocytes (median 536 pM, P < 0.001). Cessation of G-CSF administration resulted in a decline of sIL-2R levels. In contrast, five of seven patients without G-CSF treatment did not exhibit an sIL-2R increase before or at the time of engraftment. Infection was associated with a rise of sIL-2R levels. A correlation between sIL-2R levels and total leucocyte count, lymphocyte count, or CD25+ lymphocyte count was not evident. These data suggest that after autologous BMT G-CSF induces increased sIL-2R levels, which occur independent of lymphocyte activation. This may be compatible with involvement of immature bone marrow cells in G-CSF-induced sIL-2R release.
测定了19例接受大剂量化疗及自体或同基因骨髓移植(BMT)治疗霍奇金病(n = 18)或非霍奇金淋巴瘤(n = 1)患者的血清可溶性白细胞介素2受体(sIL - 2R)水平。12例患者在自体BMT后第0天或第 +1天开始接受粒细胞集落刺激因子(G - CSF),直至白细胞计数稳定在1×10⁹/L以上达9天,其余7例患者未接受生长因子治疗。在所有接受G - CSF治疗的患者中,移植后早期sIL - 2R水平稳步升高,即使在无感染的情况下也是如此。这种升高在周围血中出现白细胞前2 - 4天具有统计学意义(中位数340 pM,而BMT后立即为中位数256 pM,P < 0.025),并在首次出现周围血白细胞时达到峰值(中位数536 pM,P < 0.001)。停止给予G - CSF导致sIL - 2R水平下降。相比之下,7例未接受G - CSF治疗的患者中有5例在植入前或植入时未出现sIL - 2R升高。感染与sIL - 2R水平升高有关。sIL - 2R水平与白细胞总数、淋巴细胞计数或CD25⁺淋巴细胞计数之间无明显相关性。这些数据表明,自体BMT后G - CSF诱导sIL - 2R水平升高,这一升高独立于淋巴细胞激活发生。这可能与未成熟骨髓细胞参与G - CSF诱导的sIL - 2R释放相符。