Boiron J M, Marit G, Fabéres C, Cony-Makhoul P, Foures C, Ferrer A M, Cristol G, Sarrat A, Girault D, Reiffers J
Unité de greffe de moëlle, Hôpital Haut-Lévêque, Pessac, France.
Bone Marrow Transplant. 1993 Jul;12(1):49-55.
High-dose cyclophosphamide (HD-CY; 7 g/m2) was administered to patients suffering from high risk multiple myeloma (MM). The safety of this procedure, the recirculation and collection of peripheral blood stem cells (PBSC) and the effect of rhGM-CSF and HD-CY were studied. Group I patients (n = 21) were treated with HD-CY alone. Group II patients (n = 10) received 5 micrograms/kg/day rhGM-CSF iv after HD-CY. Neutropenia was shorter in group II (p = 0.01). In group II, the number of circulating colony forming units (CFU-GM) after 14 days was correlated with the number of circulating CFU-GM after 7 days (r = 0.85, p < 0.0001) and with the number of CD34+ cells (r = 0.839, p = 0.01). The total number of mononuclear cells (MNC) and CFU-GM collected per patient was two and seven-fold higher, respectively, in group II (p = 0.01 and p = 0.03). Recovered MNC and CFU-GM were 1.7 and 7-fold higher, respectively, in group II (p = 0.01 and p = 0.004). Our data show that HD-CY is an efficient means of collecting functional PBSC in MM. We suggest that rhGM-CSF is able to further enhance this yield in MM.
对高危多发性骨髓瘤（MM）患者给予大剂量环磷酰胺（HD-CY；7 g/m²）治疗。研究了该治疗方法的安全性、外周血干细胞（PBSC）的再循环和采集以及重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）和HD-CY的效果。I组患者（n = 21）仅接受HD-CY治疗。II组患者（n = 10）在HD-CY治疗后静脉注射5微克/千克/天的rhGM-CSF。II组患者的中性粒细胞减少期较短（p = 0.01）。在II组中，14天后循环集落形成单位（CFU-GM）的数量与7天后循环CFU-GM的数量相关（r = 0.85，p < 0.0001），并与CD34+细胞的数量相关（r = 0.839，p = 0.01）。II组中每位患者采集的单个核细胞（MNC）和CFU-GM的总数分别高出两倍和七倍（p = 0.01和p = 0.03）。II组中回收的MNC和CFU-GM分别高出1.7倍和7倍（p = 0.01和p = 0.004）。我们的数据表明，HD-CY是在MM中采集功能性PBSC的有效方法。我们建议rhGM-CSF能够进一步提高MM中的采集产量。
