Terasawa K, Sagae S, Mizumoto H, Iwasaki M, Kudo R
Dept. of Obstetrics and Gynecology, School of Medicine, Sapporo Medical University.
Gan To Kagaku Ryoho. 1998 Sep;25(11):1731-7.
High-dose chemotherapy with hematopoietic support has been expected to improve the survival of advanced ovarian cancer patients in recent years. An essential component of such treatment has been the ability to collect and reinfuse a large number of peripheral blood stem cells (PBSCs) following high dose therapy. This study was designed to determine which clinical and hematological factors would be better indicators to collect the proper volume of PBSCs. Thirteen patients received a total of 24 courses of induction chemotherapy and 69 of apheresis. We usually mobilized stem cells using CEP chemotherapy (cisplatin 50-70 mg/m2, epirubicin 50 mg/m2 and cyclophosphamide 1.5 g/m2) with G-CSF and CEE regimen (cyclophosphamide 2.0 g/m2, epirubicin 50 mg/m2, and etoposide 50 mg/m2) as a salvage for mobilization. We obtained an average 5 x 10(6)/kg of CD34+ cells for 3 days as one course. The number of CD34+ cells collected significantly depended on the platelets and reticulocytes on the first day of apheresis, but not a nadir of WBCs. It is concluded that apheresis should be started on recovery of WBCs to 5,000-10,000/microliters, of immature granulocytes to > or = 10% and of reticulocytes to > or = 20%. This study confirmed the feasibility of collecting enough PBSCs to use standard chemotherapy of ovarian cancer patients.
近年来，大剂量化疗联合造血支持被期望能提高晚期卵巢癌患者的生存率。这种治疗的一个重要组成部分是在大剂量治疗后能够采集并回输大量外周血干细胞（PBSCs）。本研究旨在确定哪些临床和血液学因素是采集适量PBSCs的更好指标。13例患者共接受了24个疗程的诱导化疗和69次单采。我们通常使用CEP化疗方案（顺铂50 - 70 mg/m²、表柔比星50 mg/m²和环磷酰胺1.5 g/m²）联合粒细胞集落刺激因子（G-CSF）动员干细胞，并使用CEE方案（环磷酰胺2.0 g/m²、表柔比星50 mg/m²和依托泊苷50 mg/m²）作为挽救性动员方案。作为一个疗程，我们在3天内平均获得了5×10⁶/kg的CD34⁺细胞。采集的CD34⁺细胞数量显著取决于单采第一天的血小板和网织红细胞数量，而不是白细胞最低点。得出的结论是，当白细胞恢复到5000 - 10000/微升、未成熟粒细胞恢复到≥10%、网织红细胞恢复到≥20%时应开始单采。本研究证实了采集足够的PBSCs用于卵巢癌患者标准化疗的可行性。
