联合化疗加重组人粒细胞集落刺激因子动员自体外周血干细胞  

Mobilization of autologous peripheral blood stem cells by combined chemotherapy and rhGCSF

作　　者：施红[1] 顾惜春[1] 朱玲[1] 杨晓云[1] 魏建平[1] 裴蕾[1] 赵夷年[1] 

机构地区：[1]北京医院血液内科,100730

出　　处：《中华肿瘤杂志》2001年第2期159-161,共3页Chinese Journal of Oncology

摘　　要：目的　观察环磷酰胺 (CTX)为主的联合化疗加重组人粒细胞集落刺激因子 (rhG CSF)对自体外周血干细胞 (APBSC)的动员效果。方法　CTX(2 5± 1 0 )g/m2 静脉点滴 ,第 1天 ;足叶乙甙(Vp 16 ) 6 0 0～ 80 0mg和 (或 )阿糖胞苷 (Ara C) 1 0～ 2 0g/m2 静脉点滴 ,第 2天。白细胞 (WBC)降至最低点时开始皮下注射rhG CSF 30 0 μg/d ,直至采集结束前一天。当WBC上升至 >3 0× 10 9/L时开始连日采集APBSC ,当单个核细胞 (MNC)累计达到 4× 10 8/kg以上时停止采集 ,并检测APBSC中的CFU GM和CD34 + 细胞。结果　 2 0例患者APBSC动员后 (8 5± 1 5 )dWBC最低 ,为 (1 2± 0 8)× 10 9/L ,(9 0±2 0 )d时开始给予rhG CSF ,持续 (6 0± 1 0 )d ,(12 0± 2 0 )d时开始采集APBSC ,持续 (4 0± 1 0 )d。采集的MNC为 (6 14± 2 34 )× 10 8/kg ,CD34 + 细胞为 (2 3 2 5± 30 5 6 )× 10 6/kg ,CD34 + 细胞升至峰值时间在化疗后 (14 6± 1 8)d ,在用rhG CSF后 (4 9± 1 6 )d ,CFU GM为 (2 1 6 8± 15 39)× 10 4 /kg;全组无严重毒副反应 ;全部移植患者造血功能均获满意重建。结论　CTX为主的联合化疗加rhG CSF是一种安全、可行的APBSC动员方法。Objective To study the effect of cyclophosphamide(CTX) combination chemotherapy and recombinant human granulocyte colonystimulating factor (rhGCSF) on autologous peripheral blood stem cells (APBSC) mobilization. Methods CTX(25±10) g/m 2 on day 1, VP16 600～800 mg and/or AraC 10～20 g/m 2 on day 2 were injected iv. rhGCSF 300 μg/d was injected sc when the white blood cell (WBC) count reached nadir until one day before APBSC harvest. When the WBC count was over 30×10 9/L, peripheral blood mononuclear cell (MNC) collection was performed once per day until the number of MNC collected was >4×10 8/kg. CFUGM colony formation and CD34 + cell enumeration were performed. [WT5”HZ]Results Twenty cases were studied. The lowest level of WBC was (12±08)×10 9/L on day 85±15 following chemotherapy. rhGCSF was given from day 90±20 and continued for 60±10 days. APBSC harvest began on day 120±20 and continued for 40±10 days. A total of (614±234)×10 8/kg MNC and (2325±3056)×10 6/kg CD34 + cells was procured. Peak level of CD34 + cells was observed 146±18 days after chemotherapy and 49±16 days after rhGCSF administration. CFUGM was (2168±1539)×10 4/kg when rhGCSF was given for 49±16 days. No severe toxic reaction was observed. Hematopoietic reconstitution was very well in all patients received APBSC transplantation. Conclusion CTX combination chemotherapy followed by rhGCSF was safe and feasible for APBSC mobilization.

关 键 词：肿瘤 联合化疗 药物疗法 重组人粒细胞集落刺激因子 自体外周血干细胞 

分 类 号：R730.5[医药卫生—肿瘤]