环磷酰胺或足叶乙甙联合粒细胞集落刺激因子动员自体外周血造血干细胞的对照研究  

Autologous Peripheral Blood Stem Cells Mobilization with Etoposide Plus rhG-CSF Versus Cyclophosphamide Plus rhG-CSF

作　　者：石远凯[1] 何小慧[1] 韩晓红[1] 刘鹏[1] 杨建良[1] 周生余[1] 周爱萍[1] 张长弓[1] 艾斌[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院内科,北京100021

出　　处：《癌症》2003年第12期1311-1316,共6页Chinese Journal of Cancer

基　　金：国家"九五"攻关课题(No.96-906-01-12);霍英东高等院校青年教师基金和教育部博士点基金(No.20010023018)

摘　　要：背景与目的:通过动员采集获得高质量的自体外周血造血干细胞(autologousperipheralbloodstemcell,APBSC)是造血干细胞移植成功的关键,环磷酰胺(cyclophosphamide,CTX)联合重组人粒细胞集落刺激因子(recombinedhumangranulocytecolony-stimulatingfactor,rhG-CSF)是APBSC经典的动员方案,足叶乙甙(etoposide,VP-16)联合rhG-CSF是近年来应用的另一个动员方案。本研究的目的是比较上述两种动员方案对恶性淋巴瘤和生殖细胞肿瘤患者APBSC的动员效果。方法:共有52例恶性实体瘤患者,其中CTX方案组26例,剂量为CTX3.5g/m2加rhG-CSF5μg·kg-1·d-1;VP-16方案组26例,VP-16的剂量随机采用1000mg/m2或1500mg/m2加rhG-CSF5μg·kg-1·d-1。两组均在白细胞(whitebloodcell,WBC)降至最低点时开始皮下注射rhG-CSF,直至采集结束前一天。当CTX组WBC恢复到2.5×109/L、VP-16组WBC恢复到5.0×109/L以上时开始连日采集APBSC,当累计采集的单个核细胞(mononuclearcell,MNC)≥5×108/kg或CD34+细胞≥2×106/kg时停止采集。患者经预处理后回输采集到的APBSC。比较两组动员采集过程中的血液学指标变化、采集细胞数量、造血重建时间、不良反应等。结果:CTX组患者化疗后外周血中WBC和血小板(platelet,PLT)降至最低值的时间明显早于VP-BACKGROUND &OBJECTIVE:It is important to get high quality autol og ous peripheral blood stem cell (APBSC) for successful peripheral blood stem cell transplantation. Cyclophosphamide (CTX) plus recombined human granulocyte colon y-stimulating factor (rhG-CSF) is standard regimen for APBSC mobilization. Eto poside plus rhG-CSF is another regimen for mobilization in recent years. The pu rpose of this study was to observe and compare the effects of these two regimens in APBSC mobilization for the patients with malignant lymphoma and germ cell tu mors. METHODS: Fifty-two patients were divided into two groups according to the regimen of mobilization. In CTX group, 26 patients were injected CTX 3.5 g/m2 i ntravenously. The other 26 patients in VP-16 group, VP-16 1000 mg/m2 or 1500 m g/m2 were given intravenously at random. All patients received rhG-CSF once dai ly as subcutaneous injection at the dose of 5 μg·kg-1·day-1 from the day of the nadir of white blood cell (WBC) till the day before the last APBSC harvest in both groups. APBSC harvest was performed daily when WBC recovered more than 2 .5×109/L in CTX group and 5.0×109/L in VP-16 group. APBSC harvest finished wh en accumulated mononuclear cells (MNCs) were more than 5×108/kg or CD34+cells were more than 2×106/kg. Collected APBSC was infused following condition regime n. Blood parameters, account of harvested cells, the time of hematopoietic recon stitute, and adverse effects were compared between two groups. RESULTS:Following administration of CTX or VP-16, the nadirs of WBC and PLT in CTX group appeare d significantly earlier than that in VP-16 group. The doses and times of rhG-C SF administration were not significantly different between the two groups. The s tart was later and the times of APBSC apheresis were less significantly in VP-1 6 group. The processed blood volume in single apheresis was more in VP-16 group . Speed and duration of single apheresis were similar in the two groups. Total M NCs were similar in the two groups, but the numbers o

关 键 词：环磷酰胺 足叶乙甙 粒细胞集落刺激因子 自体外周血造血干细胞 对照研究 肿瘤 

分 类 号：R730.5[医药卫生—肿瘤]