Olivieri A, Offidani M, Cantori I, Ciniero L, Ombrosi L, Masia M C, Brunori M, Montroni M, Leoni P
Clinica di Ematologia, Università di Ancona, Italy.
Bone Marrow Transplant. 1995 Dec;16(6):765-70.
Hemopoietic progenitor cell mobilization intended for autotransplantation is now feasible in many patients, following the administration of single cytokines (G-CSF, GM-CSF, IL-3) or their combination. Erythropoietin (EPO) is a cytokine which showed an interesting activity also on non-erythroid progenitors, however the clinical relevance of this activity has not been sufficiently investigated yet. This retrospective study has attempted to assess the effectiveness of the combination of EPO plus G-CSF after priming chemotherapy to increase the number of blood progenitor cells, as compared to the results obtained by G-CSF alone. Thirty-four patients underwent priming chemotherapy followed by cytokine administration: 18 patients received G-CSF 5 micrograms/kg/day and 16 patients G-CSF plus EPO 50 U/kg/day. The two groups were homogeneous as regards the main clinical characteristics which are thought to affect BPC mobilization. As for hemopoietic progenitor cell mobilization, we observed that the combination of EPO and G-CSF was more effective in comparison with G-CSF alone, with a median of 1.9-fold for circulating MNC, 4.0-fold for CFU-GM, 4.7-fold for BFU-E and 2.8-fold increase for CD34+ cells. The results of apheresis collections revealed that the same group of patients showed better results for total blood progenitor cells/kg. The difference was statistically significant both for BPC mobilization and collection. Our findings suggest that EPO has a synergistic activity with G-CSF in mobilizing hemopoietic progenitors; the good results obtained, despite our pretreated patients, suggest that this cytokine combination has both biologic and clinical relevance.
对于许多患者而言，在给予单一细胞因子（粒细胞集落刺激因子、粒细胞-巨噬细胞集落刺激因子、白细胞介素-3）或其组合后，用于自体移植的造血祖细胞动员现已可行。促红细胞生成素（EPO）是一种对非红系祖细胞也显示出有趣活性的细胞因子，然而这种活性的临床相关性尚未得到充分研究。这项回顾性研究试图评估在诱导化疗后，与单独使用粒细胞集落刺激因子（G-CSF）相比，促红细胞生成素（EPO）加G-CSF联合使用增加血液祖细胞数量的有效性。34例患者接受诱导化疗，随后给予细胞因子：18例患者接受5微克/千克/天的G-CSF，16例患者接受50单位/千克/天的G-CSF加EPO。两组在被认为影响骨髓祖细胞动员的主要临床特征方面是同质的。关于造血祖细胞动员，我们观察到EPO与G-CSF联合使用比单独使用G-CSF更有效，循环单核细胞（MNC）中位数增加1.9倍，粒-巨噬细胞集落形成单位（CFU-GM）增加4.0倍，爆式红系集落形成单位（BFU-E）增加4.7倍，CD34+细胞增加2.8倍。单采收集结果显示，同一组患者每千克全血祖细胞的结果更好。骨髓祖细胞动员和收集的差异均具有统计学意义。我们的研究结果表明，EPO在动员造血祖细胞方面与G-CSF具有协同活性；尽管我们的患者经过预处理，但获得的良好结果表明这种细胞因子组合具有生物学和临床相关性。
