粒系集落刺激因子对进展型多发性硬化患者造血干细胞的动员效果及安全性  

Efficacy and safety of hematopoietic stem cell mobilization by granulocyte colony-stimulation factor in patients with progressive multiple sclerosis

作　　者：徐娟[1] 冀冰心[1] 苏力[1] 孙雪静[1] 刘聪艳[1] 

机构地区：[1]首都医科大学宣武医院血液科,北京100053

出　　处：《药物不良反应杂志》2008年第5期318-321,共4页Adverse Drug Reactions Journal

基　　金："北京市教育委员会科技计划"资助项目(KM200810025001)

摘　　要：目的：观察粒系集落刺激因子（G-CSF）对进展型多发性硬化（MS）患者造血干细胞动员效果及安全性。方法：34例继发进展型MS患者纳入研究,给予G-CSF5μg/（kg·d）4～6d动员自体造血干细胞。动员后经血细胞分离机收集外周血单个核细胞。应用流式细胞术检测CD34^＋细胞和单个核细胞绝对数,并观察应用G-CSF后不良反应的类型和发生率。于动员前及动员后分别评定患者的扩展残疾状态评分（expanded disability status scale,EDSS）。结果：采集物中CD34＋细胞为（2.68±0.89）×106/kg,单个核细胞为（2.98±1.19）×108/kg。移植后中性粒细胞恢复至〉0.5×10^9/L的中位时间为13d（9～17d）,血小板恢复至〉50×10^9/L的中位时间为16d（11～21d）。移植相关死亡率为0。在G-CSF动员过程中有17例患者（50%）出现肌痛及乏力症状,未用药物治疗症状消退。2例患者在用药期间EDSS评分增加0.5分,与动员前相比差异无统计学意义（P=0.16）。结论：对于自体造血干细胞移植治疗进展型多发性硬化患者,单用G-CSF动员可以达到有效安全的临床要求。Objective： To investigate the efficacy and safety of hematopoietic stem cell mobilization by granulocyte colonystimulating factor （G-CSF） in patients with progressive multiple sclerosis （MS）. Methods： Thirty-four patients with secondary progressive MS were enrolled in a study. G-CSF 5 μg/kg daily for 4 - 6 days was used for mobilization of autologous hematopoietic stem cells. Mononuclear cells （MNCs） after mobilization were collected by blood cell separator. The absolute numbers of CD34^＋ cells and mononuclear cells were detected by flow cytometry. The type and incidence of adverse reactions were observed after G-CSF therapy. The expanded disability status scale （EDSS） was used to evaluate the condition of the patients before and after G-CSF therapy. Results： The numbers of collected CD34^＋ cells and MNCs cells were （2.68±0.89） × 10^6/kg and （2.98± 1. 19） × 10^8/kg, respectively. After transplantation, the median time of neutropil returning to 〉 0.5 ×10^8/L and platelet returning to 〉 50 ×10^9/L was 13 days （range 9-17 days） and 16 days （range 11-21 days）, respectively. Transplantation-related mortality was zero. Seventeen patients （50%） presented with muscle pain and fatigue, but the symptoms resolved without medication. Two patients experienced an increase in 0.5 points on the EDSS after mobilization by G-CSF, but no statistically significant difference was observed compared with before mobilization （P = 0.16）. Conclusion： The efficacy and safety of mobilization by G-CSF alone can meet the clinical requirement for autologous hematopoietic stem cell transplantation in treating patients with progressive MS.

关 键 词：进展型多发性硬化 粒系集落刺激因子 造血干细胞动员 有效性 安全性 

分 类 号：R744.51[医药卫生—神经病学与精神病学]