Grigg A, Begley C G, Juttner C A, Szer J, To L B, Maher D, McGrath K M, Morstyn G, Fox R M, Sheridan W P
Department of Haematology/Oncology, Royal Melbourne Hospital, Victoria, Australia.
Bone Marrow Transplant. 1993;11 Suppl 2:23-9.
The haematopoietic growth factor (HGF), granulocyte colony stimulating factor (G-CSF; filgrastim) substantially shortens the period of severe neutropenia that follows high-dose chemotherapy and autologous bone marrow infusion by stimulating granulopoiesis. Filgrastim also increases numbers of circulating progenitor cells. We have studied the ability of filgrastim to mobilise peripheral blood progenitor cells (PBPC) and assessed their efficacy when infused after chemotherapy on recovery of neutrophil and platelet counts. Seventeen patients with non-myeloid malignant disorders received filgrastim (12 micrograms/kg daily for six days) by continuous subcutaneous infusion. Numbers of granulocyte-macrophage progenitors in peripheral blood increased a median of 58-fold over pretreatment values, and numbers of erythroid progenitors increased a median of 24-fold. Three leukapheresis procedures collected a mean total of 33 (SEM 5.7) x 10(4) granulocyte-macrophage progenitors per kg body weight. After high-dose chemotherapy in 14 of the patients (busulphan and cyclophosphamide), these cells were used to augment autologous bone marrow rescue and post-transplant filgrastim treatment. Platelet recovery was significantly faster in these patients than in controls who received the same treatment apart from the infusion of peripheral blood progenitors; the platelet count reached 50 x 10(9)/L a median of 15 days after infusion of haematopoietic cells in the study patients compared with 39 days in controls (p = 0.0006). The accelerated neutrophil recovery associated with filgrastim treatment after chemotherapy was maintained. Subsequently, 10 patients received filgrastim-mobilised PBPC without marrow after high-dose chemotherapy. The rate of platelet and neutrophil recovery in these patients was at least equal to that observed in the patients receiving PBPC and bone marrow.(ABSTRACT TRUNCATED AT 250 WORDS)
造血生长因子（HGF），粒细胞集落刺激因子（G-CSF；非格司亭）通过刺激粒细胞生成，可显著缩短大剂量化疗及自体骨髓输注后严重中性粒细胞减少的持续时间。非格司亭还可增加循环祖细胞数量。我们研究了非格司亭动员外周血祖细胞（PBPC）的能力，并评估了化疗后输注这些细胞对中性粒细胞和血小板计数恢复的疗效。17例非髓系恶性疾病患者通过皮下持续输注接受非格司亭治疗（每日12微克/千克，共6天）。外周血中粒细胞-巨噬细胞祖细胞数量较治疗前值中位数增加了58倍，红系祖细胞数量中位数增加了24倍。三次白细胞分离术平均每千克体重收集到33（标准误5.7）×10⁴个粒细胞-巨噬细胞祖细胞。14例患者（接受白消安和环磷酰胺治疗）在大剂量化疗后，使用这些细胞加强自体骨髓挽救及移植后非格司亭治疗。这些患者的血小板恢复明显快于未输注外周血祖细胞而接受相同治疗的对照组；研究组患者在输注造血细胞后血小板计数中位数15天达到50×10⁹/L，而对照组为39天（p = 0.0006）。化疗后与非格司亭治疗相关的中性粒细胞加速恢复得以维持。随后，10例患者在大剂量化疗后接受了非格司亭动员的PBPC而未接受骨髓。这些患者的血小板和中性粒细胞恢复速度至少与接受PBPC和骨髓的患者相当。（摘要截短至250字）
