Lamy T, Drenou B, Grulois I, Leberre C, Dauriac C, Amiot L, Godard M, Fauchet R, LePrise P Y
Service d'hématologie clinique, Hopital Pontchaillou, F-Chu de Rennes, France.
Ann Hematol. 1994 Dec;69(6):297-302. doi: 10.1007/BF01696558.
We have tested the efficiency of GM-CSF to mobilize peripheral blood progenitor cells (PBPC) and evaluated the hematological reconstitution after GM-CSF primed-PBPC infusion following myeloablative therapy. Twenty three patients suffering from hematological malignancies were included in this study. Starting 24 hours after completion of a standard dose chemotherapy including vindesine, cyclophosphamide, adriblastine, prednisone, (VCAP), 5 micrograms/kg sub-cutaneous daily dose GM-CSF was given for a median time of 14 days followed by three consecutives cycles of leukapheresis. Fifteen of these 23 patients underwent GM-CSF primed-PBPC autotransplantation following high dosed intensification regimen. PBPC collection and hematopoietic recovery were compared with a 15 patients control group who did not receive GM-CSF. No marrow or growth factors were administered after PBPC reinfusion in the two groups. VCAP/GM-CSF mobilization induced significantly higher yields of CFU-GM (3.8 fold) than did VCAP mobilization alone, 19 x 10(4)/kg (2-73) vs 5 x 10(4)/kg (2-27), (p < 0.005). The median number of days to achieve 1.10(9)/l neutrophils, platelet count > 20.10(9)/l and > 50.10(9)/l was significantly lower in the GM-CSF group than in the control group, respectively 13 vs 19 days (p = 0.04), 15.5 vs 27 days (p < 0.02), 19 vs 51 days (p < 0.01). When compared with the control group, transfusion requirements and median of hospital stay were both significantly decreased for the patients receiving GM-CSF primed-PBPC. Our study confirms that infusion of GM-CSF primed-PBPC as a sole source of hematopoietic support improves hematopoietic reconstitution following myeloablative therapy.
我们测试了粒细胞巨噬细胞集落刺激因子（GM-CSF）动员外周血祖细胞（PBPC）的效率，并评估了清髓性治疗后GM-CSF预处理的PBPC输注后的血液学重建情况。本研究纳入了23例血液系统恶性肿瘤患者。在完成包括长春地辛、环磷酰胺、阿霉素、泼尼松（VCAP）的标准剂量化疗后24小时开始，每日皮下给予5微克/千克的GM-CSF，中位时间为14天，随后进行三个连续周期的白细胞分离术。这23例患者中有15例在接受大剂量强化方案后进行了GM-CSF预处理的PBPC自体移植。将PBPC采集和造血恢复情况与15例未接受GM-CSF的对照组患者进行比较。两组在PBPC再输注后均未给予骨髓或生长因子。VCAP/GM-CSF动员诱导的CFU-GM产量（3.8倍）显著高于单独的VCAP动员，分别为19×10⁴/千克（2-73）和5×10⁴/千克（2-27），（p<0.005）。GM-CSF组达到1.0×10⁹/升中性粒细胞、血小板计数>20×10⁹/升和>50×10⁹/升的中位天数分别显著低于对照组，分别为13天对19天（p=0.04）、15.5天对27天（p<0.02）、19天对51天（p<0.01）。与对照组相比，接受GM-CSF预处理的PBPC的患者输血需求和住院中位时间均显著降低。我们的研究证实，输注GM-CSF预处理的PBPC作为唯一的造血支持来源可改善清髓性治疗后的造血重建。
