Tuncer A M, Hiçsönmez G, Gümrük F, Sayli T, Güler E, Cetin M, Okur H
Hacettepe University, Ihsan Doğramaci Children's Hospital, Department of Pediatric Hematology, Ankara, Turkey.
Leuk Res. 1996 Mar;20(3):265-9. doi: 10.1016/0145-2126(95)00140-9.
High-dose methylprednisolone (HDMP, 20-30 mg/kg/day po) treatment has been shown to increase the number of bone marrow and peripheral blood CD34 positive progenitors and serum granulocyte-macrophage colony-stimulating factor (GM-CSF) levels in patients with ALL and AML. To investigate the effect of HDMP on some other hematopoietic regulatory cytokines, tumor necrosis factor-alpha (TNF-alpha), gamma-interferon (gamma-INF), granulocyte colony-stimulating factor (G-CSF) and interleukin-6 (IL-6) were studied by microplate ELISA technique in 15 chemotherapy-induced neutropenic episodes of 14 children with acute leukemia (eight with ALL and six with AML) in whom HDMP was given alone (30 mg/kg/day po) for 4 days. The absolute neutrophil counts increased significantly in all neutropenic episodes on the fourth day of HDMP treatment. The TNF-alpha was 93.5 +/- 161 pg/ml in ALL and 78.3 +/- 61.4 pg/ml in AML before treatment and 76.1 +/- 160 pg/ml in ALL and 19.1 +/- 39.8 pg/ml in AML after treatment. The gamma-INF was 204.1 +/- 210.3 pg/ml in ALL and 130.8 +/- 138.3 pg/ml in AML before treatment and 28.6 +/- 50.5 pg/ml in ALL and 23.3 +/- 20.4 pg/ml in AML after treatment (P<0.05). Serum G-CSF and GM-CSF levels increased in all episodes (100%). The GM-CSF levels increased from 12.2 +/- 10.9 pg/ml to 36 +/- 24.7 pg/ml after treatment in ALL (P<0.05) and from 13.3 +/- 4 pg/ml to 45 +/- 48.1 pg/ml in AML (P<0.05). Serum G-CSF levels increased from 13.3 +/- 11.7 pg/ml to 83.3 +/- 86.8 pg/ml after treatment in ALL (P<0.05) and from 6.6 +/- 12.1 pg/ml to 28.3 +/- 11.3 pg/ml in AML (P<0.05). However, IL-6 levels were undetectable in all patients before and after therapy. These preliminary data suggest that short-course HDMP treatment could decrease serum TNF-alpha and gamma-INF and increase G-CSF and GM-CSF levels.
大剂量甲基强的松龙（HDMP，口服20 - 30毫克/千克/天）治疗已显示可增加急性淋巴细胞白血病（ALL）和急性髓细胞白血病（AML）患者骨髓及外周血中CD34阳性祖细胞数量以及血清粒细胞-巨噬细胞集落刺激因子（GM - CSF）水平。为研究HDMP对其他一些造血调节细胞因子的影响，采用微孔板酶联免疫吸附测定（ELISA）技术，对14例急性白血病患儿（8例ALL和6例AML）的15次化疗诱导的中性粒细胞减少发作进行了研究，这些患儿单独给予HDMP（口服30毫克/千克/天），共4天。在HDMP治疗的第4天，所有中性粒细胞减少发作的绝对中性粒细胞计数均显著增加。治疗前ALL患者的肿瘤坏死因子-α（TNF-α）为93.5±161皮克/毫升，AML患者为78.3±61.4皮克/毫升；治疗后ALL患者为76.1±160皮克/毫升，AML患者为19.1±39.8皮克/毫升。治疗前ALL患者的γ干扰素（γ-INF）为204.1±210.3皮克/毫升，AML患者为130.8±138.3皮克/毫升；治疗后ALL患者为28.6±50.5皮克/毫升，AML患者为23.3±20.4皮克/毫升（P<0.05）。所有发作中血清G - CSF和GM - CSF水平均升高（100%）。ALL患者治疗后GM - CSF水平从12.2±10.9皮克/毫升升至36±24.7皮克/毫升（P<0.05），AML患者从13.3±4皮克/毫升升至45±48.1皮克/毫升（P<0.05）。ALL患者治疗后血清G - CSF水平从13.3±11.7皮克/毫升升至83.3±86.8皮克/毫升（P<0.05），AML患者从6.6±12.1皮克/毫升升至28.3±11.3皮克/毫升（P<0.05）。然而，治疗前后所有患者的白细胞介素-6（IL - 6）水平均未检测到。这些初步数据表明，短疗程HDMP治疗可降低血清TNF-α和γ-INF水平，并升高G - CSF和GM - CSF水平。
