环磷酰胺和重组人粒细胞巨噬细胞集落刺激因子动员多发性骨髓瘤患者外周血祖细胞

Mobilization of peripheral blood progenitor cells by cyclophosphamide and rhGM-CSF in multiple myeloma.

作者信息

Martínez E, Sureda A, Dalmases C D, Sánchez J A, Amill B, Tugues D, Sardá P, Miralles A, Brunet S, Domingo-Albós A, García J

机构信息

Department of Cryobiology and Cell Therapy, Hospital Duran i Reynals, Barcelona, Spain.

出版信息

Bone Marrow Transplant. 1996 Jul;18(1):1-7.

PMID:8831988

Abstract

Fifteen consecutive patients with multiple myeloma (MM) scheduled for peripheral blood progenitor cell (PBPC) transplantation, were randomly selected to receive cyclophosphamide (CY) (4 g/m2) alone (group I) or associated with recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) (5 micrograms/kg/day) (group II). The mean time of neutropenia after CY administration was 9.8 +/- 4.3 days in group I and 6.4 +/- 1.2 days in group II (P = 0.0228). One hundred and eight aphereses were performed (7.1 +/- 1.8 aphereses per patient in group I and 6.4 +/- 2.8 aphereses per patient in group II). rhGM-CSF administration after CY allowed a higher collection of CD34+ cells in apheresis products (1.42 +/- 1.68 x 10(6) CD34+ cells/kg) in comparison to without factor administration (0.47 +/- 0.52 x 10(6) CD34+ cells/kg) (P = 0.0165). The mean number of cells infused per patient was 6.56 +/- 4.02 x 10(8) MNC/kg and 7.64 +/- 3.00 x 10(4) CFU-GM/kg in group I and 6.25 +/- 4.03 x 10(8) MNC/kg and 8.16 +/- 9.73 x 10(4) CFU-GM/kg in group II. The mean time to recover 0.5 x 10(9) granulocytes/I, 20 and 50 x 10(9) platelets/I in peripheral blood (PB) was 17.2 +/- 7.4, 13.4 +/- 3.7 and 16.5 +/- 6.9 days respectively, in group I and 13.3 +/- 1.7, 11.6 +/- 1.6 and 15 +/- 6.3 days, in group II. rhGM-CSF administration after CY treatment for PBPC mobilization in MM patients reduces the neutropenic period after CY and enhances apheresis CD34+ cell collection.

摘要

连续选取15例计划进行外周血祖细胞（PBPC）移植的多发性骨髓瘤（MM）患者，随机分为两组，一组单独接受环磷酰胺（CY）（4 g/m²）治疗（I组），另一组在接受CY治疗的基础上联合重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）（5微克/千克/天）治疗（II组）。I组CY给药后中性粒细胞减少的平均时间为9.8±4.3天，II组为6.4±1.2天（P = 0.0228）。共进行了108次单采（I组每位患者平均单采7.1±1.8次，II组每位患者平均单采6.4±2.8次）。与未使用rhGM-CSF相比，CY给药后使用rhGM-CSF可使单采产品中CD34⁺细胞的采集量更高（1.42±1.68×10⁶个CD34⁺细胞/千克）（未使用因子时为0.47±0.52×10⁶个CD34⁺细胞/千克）（P = 0.0165）。I组每位患者输注的平均细胞数为6.56±4.02×10⁸个有核细胞/千克和7.64±3.00×10⁴个粒系集落形成单位/千克，II组为6.25±4.03×10⁸个有核细胞/千克和8.16±9.73×10⁴个粒系集落形成单位/千克。I组外周血（PB）中粒细胞恢复至0.5×10⁹/升、血小板恢复至20×10⁹/升和50×10⁹/升的平均时间分别为17.2±7.4天、13.4±3.7天和16.5±6.9天，II组分别为13.3±1.7天、11.6±1.6天和15±6.3天。MM患者CY治疗后使用rhGM-CSF进行PBPC动员可缩短CY后的中性粒细胞减少期，并提高单采CD34⁺细胞的采集量。