各种动员剂方案在恶性淋巴瘤自身外周血造血干细胞移植中的应用  

Effects of various agents used for mobilization of peripheral stem cells for autologous transplantation in malignant lymphoma patients

作　　者：俞受程[1] 张伟京[1] 邓春江[1] 阎安文 马恩普 刘秀珍 苏航[1] 鲍云华[1] 

机构地区：[1]军事医学科学院附属医院

出　　处：《军事医学科学院院刊》1997年第2期98-104,共7页Bulletin of the Academy of Military Medical Sciences

摘　　要：对３组共２０例恶性淋巴瘤病人进行自身外周血干细胞回输，采用了（１）皮质激素；（２）硫酸葡聚糖（ｄｅｘｔｒａｎｓｕｌｆａｔｅ，ＤＳ）；（３）粒细胞集落刺激因子（Ｇ－ＣＳＦ）或环磷酰胺（ＣＴＸ）＋Ｇ－ＣＳＦ等３组不同的动员剂和治疗方案。结果显示，１组口服泼尼松或静脉注射地塞米松可使白细胞（ＷＢＣ）明显增多，是给药前自身血的４．６１倍和７．２４倍；２组ＷＢＣ、单个核细胞（ＭＮＣ）和粒细胞巨噬细胞集落生成单位（ＣＦＵ－ＧＭ）分别为用药前的２．０４倍、４．１４倍和２．０４倍；３组平均分离２．６次，总细胞数可获得ＷＢＣ１５．４７×１０９、ＭＮＣ１３．８９×１０９、ＣＦＵ－ＧＭ２５．４×１０５、ＣＤ３４＋细胞１３．２４×１０７。ＷＢＣ、ＭＮＣ分别为动员前的３．６倍和３．９倍。临床应用：１组化疗采用ＣＴＸ＋长春新碱（ＶＣＲ）方案输入干细胞后可以加速造血恢复；２组化疗采用大剂量环磷酰胺、阿霉素、鬼臼毒素和泼尼松（ＣＨＶＰ）方案，输后１４ｄＷＢＣ恢复至４×１０９个／Ｌ以上，血小板（Ｐｔ）在输后１６ｄ恢复照前水平；３组化疗采用大剂量ＣＨＶＰ或超大剂量环己亚硝脲、鬼臼毒素、环磷酰胺（ＢＶＰＣ）方案。输后５ｄＷＢＣ降至０．０５×１０?Twenty patients with malignant lymphoma were divided into three groups. They were treated with transplantation of autologous peripheral stem cells mobilized by three kinds of agents and chemotherapeutic schemes. The results were as follows: 1. Hormone group: prednisone or dexamethasone was used. WBC was increased significantly, being 4.61 and 7.24 times higher than pre mobilization. After chemotherapy (CTX+VCR), MNC (2.11×10 9 and 2.40×10 9) and CFU GM (0.72×10 5 and 0.33×10 5) were reinfused. Hemopoietic reconstitution was hastened. 2. Dextran sulfate (DS) group: 10% DS 9—10 ml in normal saline 100 ml was given iv. The WBC, MNC and CFU GM were 2.04, 4.14 and 2.04 times higher than pre mobilization respectively. After chemotherapy (CHVP), the total MNC (5.5×10 9) and CFU GM (1.54×10 5) were remfused. WBC increased to more than 4×10 9 in 14 days, while platelet count returned to normal level after 16 days. 3. G CSF or CTX+G CSF group: after high dose chemotherapy or superhigh dose chemotherapy (CHVP or BCNU+Vp 16+CTX), the total WBC (15.47×10 9), MNC (13.89×10 9), CFU GM (25.4×10 5) and CD34 + cells (13.24×10 7) were reinfused. WBC increased to more than 2.2×10 9/L in 16 days, while platelet was 50×10 9/L after 19 days. In the group using G CSF or CTX+G CSF, WBC and MNC were increased significantly, being 3.6 and 3.9 times higher than pre mobilization. Therefore, the third one was an ideal stem cell mobilizing agent with satisfactory effect for tumor remission.

关 键 词：淋巴瘤 造血干细胞 移植 动员剂 

分 类 号：R733.405[医药卫生—肿瘤] R730.58[医药卫生—临床医学]