【摘要】 19例临床应用重组人粒/巨噬细胞集落刺激因子(recombinant humangranulocyte-macrophnge colony-stimulating factor,rhGM-CSF),其中4例药物过敏所致急性粒细胞缺乏症,5例恶性肿瘤强烈化疗后粒细胞缺乏合并感染,8例白血病接受大剂量放、化疗后造血干细胞移植合并感染,2例应用rhGM-CSF动员外周血干细胞移植治疗白血病和骨髓增生异常综合征。结果提示药物过敏所致粒细胞缺乏症用药2～8天白细胞回升,疗效最佳;5例恶性肿瘤化疗所致粒细胞缺乏,4例在用药后2～12天白细胞回升,感染控制,另1例用药4天,血像无变化,死于原发病和感染;8例造血干细胞移植骨髓抑制合并感染,用药后血像回升,造血重建,感染治愈;2例用rhGM-CSF动员自体外周血干细胞,初步观察用药后有核细胞总数增高不明显,但单个核细胞较多(80％～100％)。本系列剂量在2.5～6μg/kg/d静脉点滴或皮下注射,用药过程均感乏力,其中1例有恶心,未发现其它严重毒副作用。本文结合文献复习对rhGM-CSF临床应用的有关问题进行讨论。更多还原

【Abstract】 We have studied the clinical use of rhGM-CSF in 19 patients. Among them, 4 cases were with acute agranulocytosis caused by drug, 5 cases with agranulocytosis and severe infection following chemotherapy for malignancy, 8 with infection after full doses radiotherapy(TBI) and high-dose chemotherapy used as conditioning for hematopoietic stem cell transplantation, and in 2 cases rhGM-CSF was used as a mobilizer for peripheral blood stem cell transplantation. WBC count began to increase on 2-8 days after administration of rhGM-CSF in cases of drug-induced agranulocytosis, and on 3-12 days in 4 of the 5 cases with malignancy after the infection was under control, but the 5th case died of infection despite the administration of rhGM-CSF for 4 days. In 8 cases of hematopoietic stem cell transplantation, hemopoietic reconstitution and control of infection were achieved following rhGM-CSF administration. In 2 cases of peripheral blood stem cell transplantation, there was no increase of nucleated cells (NC) in the peripheral blood, but the percentage of the blood mononuclear cells (MNC) increased by 80%-100%. When rhGM-CSF was injected with dosage of 2.5-6μg/kg/d intravenously or subcutaneously, in all patients fatique occurred during the administration and 1 patient had a nousea. No other adverse reaction was noticed. Some aspects in the clinical use of rhGM-CSF were commented.更多还原