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接受减瘤化疗的急性白血病和非霍奇金淋巴瘤患者体内集落刺激因子、白细胞介素-6和白细胞介素-10的血浆水平调控情况。

Regulated plasma levels of colony-stimulating factors, interleukin-6 and interleukin-10 in patients with acute leukaemia and non-hodgkin's lymphoma undergoing cytoreductive chemotherapy.

作者信息

Reisbach G, Kamp T, Welzl G, Geiz C, Lodri A, Kaboth W, Dörmer P, Nerl C

机构信息

Gsf- Forschungszentrum für Umwelt und Gesundheit, Institut für Experimentelle Hämatologie, München, Germany.

出版信息

Br J Haematol. 1996 Mar;92(4):907-12. doi: 10.1046/j.1365-2141.1996.434972.x.

DOI:10.1046/j.1365-2141.1996.434972.x
PMID:8616084
Abstract

Endogenous plasma levels of granulocyte colony stimulating factor (G- CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF),IL-6 and IL-10 were measured in a total of 70 patients undergoing cytoreductive chemotherapy for treatment of acute leukaemia or non-Hodgkin's lymphomas. the diagnoses were acute myeloid leukaemia (AML; n = 30), acute lymphoblastic leukaemia (ALL;n=6), non-Hodgkin's lymphomas (NHL; n=11) and other malignant haematological disorders including myelodysplastic syndromes (n=23). After chemotherapy, plasma G-CSF was elevated (mean 5.6 ng/ml; range 1.2-10 ng/ml), and was inversely correlated with white blood cell counts (WBC) (r=-0.7, p<0.001). Occurrence of fever (T>38.0 degrees C) during severe myelosuppression (WBC<1x10(9)/1) was associated with an additional increase of G-CSF levels (P<0. (P<0.001). Plasma IL-6 correlated significantly with fever (range <1 to 1100 pg/ml, mean 130 pg/ml; r=0.5, P<0.001) but revealed only a weak association with WBC or platelet counts. In patients treated with recombinant G-CSF (n = 9), an association between IL-6 and fever was still observed after chemotherapy. During the nonfebrile status (total n = 242; AML n = 124), IL-6 levels remained <9 pg/ml in 90% of cases, whereas G-CSF increased with leucopenia (r = -0.72;P<0.001). In contrast, endogenous GM-CSF remained normal and IL-10 showed only a slight increase (21% of samples; maximum 22 pg/ml) in severe leucopenia. In particular, IL-10 levels did not correlate with G-CSF or IL-6 levels. We conclude that systemic release of G-CSF and IL-6 is obviously nit abrogated by cytoreductive chemotherapy in acute leukaemia and NHL may add to the therapeutic efficacy of recombinant cytokines. Also, plasma levels of G-, GM-CSF or IL-6 appear to be regulated by separate mechanisms.

摘要

在总共70例接受减瘤化疗以治疗急性白血病或非霍奇金淋巴瘤的患者中,检测了内源性血浆粒细胞集落刺激因子(G-CSF)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-6(IL-6)和白细胞介素-10的水平。诊断包括急性髓系白血病(AML;n = 30)、急性淋巴细胞白血病(ALL;n = 6)、非霍奇金淋巴瘤(NHL;n = 11)以及其他恶性血液系统疾病,包括骨髓增生异常综合征(n = 23)。化疗后,血浆G-CSF升高(平均5.6 ng/ml;范围1.2 - 10 ng/ml),且与白细胞计数(WBC)呈负相关(r = -0.7,p < 0.001)。在严重骨髓抑制(WBC < 1×10⁹/L)期间发热(T > 38.0℃)的发生与G-CSF水平的进一步升高相关(P < 0.001)。血浆IL-6与发热显著相关(范围<1至1100 pg/ml,平均130 pg/ml;r = 0.5,P < 0.001),但与WBC或血小板计数仅显示出微弱关联。在接受重组G-CSF治疗的患者(n = 9)中,化疗后仍观察到IL-6与发热之间的关联。在无发热状态期间(总共n = 242;AML n = 124),90%的病例中IL-6水平保持<9 pg/ml,而G-CSF随着白细胞减少而升高(r = -0.72;P < 0.001)。相比之下,内源性GM-CSF保持正常,IL-10在严重白细胞减少时仅略有升高(21%的样本;最高22 pg/ml)。特别是,IL-10水平与G-CSF或IL-6水平不相关。我们得出结论,急性白血病和NHL的减瘤化疗显然并未消除G-CSF和IL-6的全身释放,这可能会增加重组细胞因子的治疗效果。此外,G-、GM-CSF或IL-6的血浆水平似乎受不同机制调节。

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