Goto H, Shimazaki C, Hirata T, Ashihara E, Ohkawa K, Oku N, Inaba T, Fujita N, Nakagawa M
Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan.
Acta Haematol. 1993;89(3):144-8. doi: 10.1159/000204507.
Because recombinant human granulocyte colony-stimulating factor (G-CSF) has been reported to increase the sensitivity of acute myelogenous leukemia (AML) blast cells to cytosine arabinoside (Ara-C) in vitro, we treated a patient with refractory AML with an Ara-C-based regimen in combination with G-CSF (G-CSF/Ara-C therapy). G-CSF (50 micrograms/m2/day, subcutaneous injection) was administered simultaneously with a continuous intravenous infusion of Ara-C (70 mg/m2/day). Complete remission was achieved, however, severe neutropenia, documented infection, stomatitis, and diarrhea were observed. In vitro studies using 3H-thymidine uptake and dual parameter flow-cytometric analysis of DNA and proliferating cell nuclear antigen showed that leukemic blast cells in S phase were increased after incubation with G-CSF. G-CSF also enhanced expression of the transferrin receptor (CD71) on blast cells in vitro. These observations suggest that G-CSF/Ara-C therapy may be useful in the treatment of high-risk AML.
由于有报道称重组人粒细胞集落刺激因子（G-CSF）可在体外提高急性髓性白血病（AML）原始细胞对阿糖胞苷（Ara-C）的敏感性，我们采用基于阿糖胞苷的方案联合G-CSF（G-CSF/阿糖胞苷疗法）治疗了一名难治性AML患者。G-CSF（50微克/平方米/天，皮下注射）与阿糖胞苷持续静脉输注（70毫克/平方米/天）同时给药。患者实现了完全缓解，然而，观察到严重的中性粒细胞减少、有记录的感染、口腔炎和腹泻。使用3H-胸腺嘧啶核苷摄取以及DNA和增殖细胞核抗原的双参数流式细胞术分析进行的体外研究表明，与G-CSF孵育后，处于S期的白血病原始细胞增加。G-CSF还在体外增强了原始细胞上转铁蛋白受体（CD71）的表达。这些观察结果表明，G-CSF/阿糖胞苷疗法可能对高危AML的治疗有用。
