中剂量环磷酰胺或增大环磷酰胺剂量的常规化疗联合G-CSF动员恶性肿瘤患者外周血造血祖细胞  

Middle-high dose of cyclophosphamide or conventional routine chemotherapy with increased dose of cyclophosphamide combined with G-CSF for mobilizing peripheral blood progenitor cells in patients with tumor

作　　者：陆道培[1] 刘开彦[1] 郭乃榄[1] 石远凯[2] 何晓慧[2] 楼方定[3] 达万明[3] 张伯龙[3] 王良绪[4] 克晓燕[4] 

机构地区：[1]北京大学人民医院,北京大学血液病研究所,100044 [2]中国医学科学院,中国协和医科大学肿瘤医院 [3]解放军第三〇一医院 [4]北京大学第三医院

出　　处：《中华血液学杂志》2003年第2期68-70,共3页Chinese Journal of Hematology

摘　　要：目的　多中心临床研究糖基化的G CSF联合中剂量环磷酰胺 (Cy)或增大针对性联合化疗中Cy剂量动员自体外周血造血祖细胞的效果。方法　北京地区 4所医院 30例患者纳入方案。其中非霍奇金淋巴瘤 (NHL) 2 1例 ,霍奇金病 (HD) 1例 ,乳腺癌 7例及卵巢癌 1例。采用中剂量Cy或以增大Cy剂量为基础的针对性化疗联合G CSF动员自体外周血造血祖细胞 (APBPC)。在化疗后白细胞计数达最低值时开始应用G CSF。当白细胞升至 5 .0× 10 9 L以上时 ,用血细胞分离机采集。结果　Cy平均实际使用剂量为 3.95g(2 .3g m2 ) ;G CSF的剂量分别为 2 5 0 μg d(2 9例 ) ,5 0 0 μg d(1例 ) ,实际剂量3 1～ 6 .4 μg·kg- 1 ·d- 1 。 30例患者平均采集 2 .7次 ,其中 13例采集 2次 ,14例采集 3次 ,3例采集 4次。达到目标采集量单个核细胞≥ 6× 10 8 kg为 2 1例 (70 .0 % ) ,CD34 + 细胞≥ 2× 10 6 kg为 30例 (10 0 % ) ,CFU GM≥ 2× 10 5 kg为 2 4例中 15例 (6 2 .5 % )。 1次采集后 2 7例 (90 .0 % )、2次采集后 2 9例 (96 .7% )患者达到了CD34+ 细胞数目标采集量。结论　G CSF 2 5 0 μg d联合中剂量Cy或以增大Cy剂量为基础的针对性化疗可采集到足够数量的APBPC。Objective To investigate the clinical value of glycosylated G CSF combined with middle high dose cyclophosphamide (Cy) or conventional chemotherapy with increased dose of Cy for mobilizing peripheral blood progenitor cells in patients with tumor. Methods Thirty patients from four hospitals in Beijing region were enrolled in this clinical study. Diagnoses of the patients were non Hodgkin' lymphoma (n=21), Hodgkin disease(n=1), breast cancer (n=7) and ovary cancer (n=1). Autologous peripheral blood progenitor cells (APBPC) were mobilized by middle high dose Cy or conventional chemotherapy with increased dose of Cy combined with G CSF. G CSF was given subcutaneously from the nadir of the white blood cell (WBC) count to the end of PBPC collection. The dosage of G CSF was 250?μg/d in 29 patients and 500 μg/d in 1 patient. When WBC count was > 5×10 9/L, APBPC were harvested with CS 3000 plus/COBE Spectra. Results The average dosage of Cy was 3.95 g(2.3 g/m 2 ). The doses of G CSF were 3.1～6.4?μg·kg -1 ·d -1 . Thirteen patients(43%) were collected twice, 14 patients (47%) three times and 3 patients (10%) four times. All of the patients could tolerate the treatment regimens. Seven patients had bone pain after G CSF injection and one was severe, one patient had headache and one had nausea and vomiting. Conclusion 250 μg glycosylated G CSF combined with middle high Cy or conventional chemotherapy with increased dose of Cy combined G CSF is an optimal method for APBPC mobilization in tumor patients.

关 键 词：环磷酰胺 剂量 多中心临床研究 常规化疗 G—CSF 恶性肿瘤 外周血造血祖细胞 

分 类 号：R730.5[医药卫生—肿瘤]