干细胞动员时提前应用粒系集落刺激因子对患者发热及感染的影响  

The effect of earlier administrating granulocyte colony-stimulating factor on patients' fever and infection

作　　者：盛蓉[1] 刘文超[1] 薛妍[1] 郭晓彤[1] 斯小明[1] 黄颖[1] 

机构地区：[1]第四军医大学西京医院肿瘤中心,陕西西安710032

出　　处：《中国癌症杂志》2007年第7期514-516,共3页China Oncology

基　　金：全军医药卫生科研基金(06MA205);国家自然科学基金(3067291)

摘　　要：背景与目的：造血干细胞移植一直被广泛应用于恶性肿瘤和恶性血液系统疾病的治疗,甚至在一些良性疾患中也有应用,如再生障碍性贫血等。造血干细胞的动员也同样被广泛应用。由于移植过程中的高风险,任何能够增加造血干细胞的回收率和简化造血干细胞采集的方法都有望提高造血干细胞移植的成功率。因此本文研究旨在观察提前给予粒系集落刺激因子（在白细胞介于1×10^9-2×10^9/L时）,是否影响干细胞采集的数量和患者感染、发热的发生率。方法：对70例恶性肿瘤患者按随机单双号顺序进入A组和B组。全部患者给予环磷酰胺4 g/m2化疗,分别在白细胞≤1×10^9/L后（A组）和介于1×10^9-2×10^9/L（B组）时,皮下注射粒系集落刺激因子（惠尔血）5μg/kg。在白细胞回升至2×10^9/L以上时,分2-3次采集外周血造血干细胞,同时计数单个核细胞和CD34＋细胞数量。结果：A组采集单个核细胞数量平均为4.34×10^8/kg;B组为3.8×10^8/kg（P〉0.75）。CD34＋细胞A组为2.62×10^6/kg;B组为2.97×10^6/kg（P〉0.9）。感染、发热的发生率A组为18/33;B组为8/35（P〈0.01）。结论：提前给予粒系集落刺激因子（G-CSF）不会影响外周血造血干细胞采集的数量,而发热和感染的发生率却显著降低。Background and purpose： Peripheral blood stem cell transplantation （PBSCT） has been broadly used in the treatment of solid malignant tumors and hematological malignancies, and even some benign diseases such as aplastic anemia. Mobilization of stem cells （ CD34 ＋） has also been broadly used in the clinic. Improvement in the methods, they may collect more stem cells or simplify the procedure of the mobilization may increase the possibility of PBSCT since it may reduce the risk during the transplantation. This study was to investigate whether granulocyte colony-stimulating factor （ G- CSF） that was administrated when the white blood cells between 1 ×10^9-2× 10^9/L could affect the quantity of stem cells and the onset of fever and infection of patients. Methods： 70 patients with malignant tumor were randomly enrolled into group A or B. All patients received cyclophosphamide 4 g/m^2 and G-CSF at 5 μg/kg was injected subcutaneously when WBC ≤ 1 × 10^9/L （ group A） or between 1 ×10^9-2×10^9/L （ group B ）. The stem cells were collected 2-3 times when the leukocyte count increased to 2 × 10^9/L or more. The quantity of the monoclonal nuclear cells and CD34 ＋ cells were examined at the same time. Results： The average number of the monoclonal nuclear cells was 4.34 ×10^8/kg in group A, 3.8 × 10^8/kg in group B （ P 〉0.75） . The number of the CD34 ＋ cells was 2.62 × 10^6/kg in group A and 2.97 × 10^6/kg in group B（ P 〉 0.25）. For the patients with fever and infection it was 18/33 in group A, 8/35 in group B（ P 〈 0. 01）. Conclusions： Patients receiving G-CSF earlier do not have interference with the quantity of the collected stem cells whereas it could reduce the possibility of the fever and infection during PBSCT.

关 键 词：粒系集落刺激因子 动员 干细胞 

分 类 号：R730.54[医药卫生—肿瘤]