Schuening F G, Nemunaitis J, Appelbaum F R, Storb R
Fred Hutchinson Cancer Research Center, Seattle, WA 98104-2092.
Bone Marrow Transplant. 1994;14 Suppl 4:S74-7.
The use of hematopoietic growth factors after allogeneic bone marrow transplantation (BMT) was investigated either in a preclinical canine model or in patients. G-CSF administration in dogs after high-dose total body irradiation (TBI) and transplantation of DLA-identical littermate marrow significantly accelerated recovery of peripheral blood neutrophils, monocytes and lymphocytes, but not of platelet counts, without significantly increasing the risks of graft failure or graft-versus-host disease (GVHD). GM-CSF given to patients after HLA-identical sibling BMT was well tolerated at doses < or = 250 micrograms/m2/day and resulted in significantly faster neutrophil recovery compared with matched historical controls. Risks of graft failure, GVHD or relapse were not increased. When GM-CSF was given after matched or 1-antigen mismatched unrelated BMTs, the number of febrile days and septic episodes within the first 28 days was reduced even though neutrophil recovery was not accelerated. Incidences of graft failure, GVHD or relapse were not increased. In recipients of BMT with invasive fungal infections, M-CSF in combination with conventional anti-fungal therapy may have a beneficial effect on survival. Treatment with GM-CSF in patients with graft failure appears to result in improved survival without increasing the risks of GVHD or relapse.
在临床前犬类模型或患者中研究了异基因骨髓移植（BMT）后造血生长因子的使用情况。在大剂量全身照射（TBI）和移植DLA相同的同窝骨髓后给犬使用G-CSF，可显著加速外周血中性粒细胞、单核细胞和淋巴细胞的恢复，但对血小板计数无显著影响，且不会显著增加移植失败或移植物抗宿主病（GVHD）的风险。在 HLA 相同的同胞 BMT 后给患者使用 GM-CSF，剂量≤250 微克/平方米/天耐受性良好，与匹配的历史对照相比，中性粒细胞恢复明显更快。移植失败、GVHD 或复发的风险未增加。在匹配或 1 个抗原不匹配的无关 BMT 后给予 GM-CSF 时，尽管中性粒细胞恢复未加速，但前 28 天内发热天数和败血症发作次数减少。移植失败、GVHD 或复发的发生率未增加。在患有侵袭性真菌感染的 BMT 受者中，M-CSF 与传统抗真菌治疗联合使用可能对生存有有益影响。在移植失败的患者中使用 GM-CSF 治疗似乎可提高生存率，而不会增加 GVHD 或复发的风险。
