环磷酰胺联合G-CSF动员外周血造血干细胞的实验和临床观察  

Experimental and Clinical Study on Autologous Peripheral Blood Stem Cells Mobilized by Cyclophosphamide and Granulocyte-Colony Stimulating Factor (G-CSF)

作　　者：黄慧强[1] 管忠震[1] 何友兼[1] 姜文奇[1] 孙晓菲[1] 邢献志[2] 牛京娜[2] 孔庆瑜[3] 陈惠珍[3] 何利蓉[1] 冯海宁[1] 

机构地区：[1]中山医科大学肿瘤医院,广州市510060 [2]第一军医大学南方医院 [3]中山医科大学第一附属医院

出　　处：《中国肿瘤临床》2001年第11期809-812,共4页Chinese Journal of Clinical Oncology

基　　金：国家"九五"攻关项目部分资助(96-906-01-12)

摘　　要：目的:评价环磷酰胺(CTX)联合G-CSF(粒细胞集落刺激因子)对自体外周血造血干细胞(PBSC)的动员效果和毒性反应。方法:CTX3.5～4g/m2第1、2天静滴,WBC降至最低点时开始注射G-CSF4.5(3.5～5)μg/kg·天,至PBSC采集结束。当WBC恢复至(1.9～3.0)×109/L以上,以及MNC(单个核细胞)≥20%～30%和外周血CD34+≥1%时采集APBSC,当累计采集MNC≥2.0×108/kg和CD34+细胞≥2.0×106/kg时停止采集。结果:23例患者经CTX+G-CSF动员后第9(7～10)天WBC最低,为0.65(0.25～0.9)×109/L,G-CSF给药开始时间为动员后第10(8～11)天,持续6.5(5～11)天,第13(11～20)天开始采集PBSC,持续2天,采集得MNC2.5(1.3～8.9)×108/kg,CFU-GM6.8(2.8～11.6)×105/kg,CD34+细胞4.9(2.5～8.9)×106/kg,1例患者出现心包炎,无其他严重毒性反应;21例接受自体外周血干细胞移植支持下超大剂量化疗均获得满意造血重建。结论:CTX联合G-CSF是高效和安全的PBSC动员方案,值得临床广泛应用。Objective:To evaluate the efficacy and toxicity of cyclophosphamide(CTX)and G-CSF in mobilization of autologous peripheral blood stem cells(PBSC).Methods:CTX3.5～4g /m 2 was administered intravenously at day1and2.G-CSF4.5(3.5～5)ug /kg /d was given subcutaneously from the nadir of leucopenia to the end of PBSC harvest.PBSC collection was started when WBC>1.9～3.0×10 9 /L,MNC≥1%and CD 34+ ≥1%and discontinued when MNC2.0×10 8 /kg.CD 34+ cells detection,CFU-GM culture and CD 34+ CD 38- /CD 34+ CD 38- of PBSC for some of the patients were performed.Results:Twenty-three patients underwent PBSC mobilization by CTX+G-CSF.The nadir of WBC was0.65(0.25～0.9)×10 9 /L at day9(7～10).G-CSF was initiated at day10(8～11)for median6.5(5～11)days.Harvest of PBSC began at day13(11～20)for2successive days.Accumulated MNC2.5(1.3～8.9)×10 8 /kg,CFU-GM6.8(2.8～11.6)×10 5 /kg,CD 34+4.9(2.5～8.9)×10 6 /kg were collected.No severe toxicity was observed.Prompt and sustained hematopoietic reconstitution were obtained in22patients received autologous peripheral bloos stem cell transplatation.Conclusion:Cyclophosphamide plus G-CSF is a safe and highly efficient combination for PBSC mobilization.

关 键 词：环磷酰胺 自体外周血干细胞 粒细胞集落刺激因子 恶性肿瘤 细胞移植 

分 类 号：R730.5[医药卫生—肿瘤]