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化疗加G-CSF和GM-CSF联合动员自体外周血干细胞

Mobilization of autologous peripheral blood stem cells by chemotherapy and recombinant granulocyte colony stimulating factor(G-CSF) and granulocyte macrophage colony stimulating factor(GM-CSF)

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【作者】 崔秀珍邵莹任宝柱佟仲生任秀宝李丽庆张执萍张乃宁戴荣增郝希山

【Author】 CUI Xiu zhen,SHAO Ying,REN Baozhu,et al.Cancer Institute and Hospital,Tianjin Medical College,Tianjin 300060,China

【机构】 天津医科大学肿瘤医院、肿瘤研究所天津医科大学肿瘤医院、肿

【摘要】 目的 探讨化疗加粒细胞集落刺激因子 (G CSF)和粒 巨噬细胞集落刺激因子 (GM CSF)联合动员自体外周血干细胞 (APBSC)的效果。方法 卡铂 (CBP) 35 0mg m2 ,第 1天静滴 ;足叶乙甙(Vp16 ) 35 0mg m2 ,第 1~第 3天静滴 ;白细胞降至最低点又回升到 (2 .4~ 6 .4)× 10 9 L时 ,皮下注射G CSF 5 μg·kg- 1 ·d- 1 (早 6∶0 0 ) +GM CSF 5 μg·kg- 1 ·d- 1 (晚 6∶0 0 ) +地塞米松 5mg d(采集日 10mg d)直到采集结束前 1天 ;白细胞上升到 (2 9.80± 5 .98)× 10 9 L ,开始用CS30 0 0plus血细胞分离机连续 2d采集APBSC。结果  2 0例患者连续采集APBSC 2次 ,共采集到MNC(5 .93± 1.6 2 )× 10 8 kg ,CD34+ 细胞 (2 3.10± 11.5 3)× 10 6 kg ,CFU GM(3.44± 2 .85 )× 10 5 kg。无严重不良反应。 9例 10次自体外周血干细胞移植(APBSCT)造血功能均获满意重建。结论 以化疗联合G CSF和GM CSF能高效、安全地动员APBSC ,1次动员采集 2次可满足 1~ 2次的APBSCT。

【Abstract】 Objective To observe the efficacy of chemotherapy and recombinant granulocyte colony stimulating factor(G CSF,Glycosylated)and granulocyte macrophage colony stimulating factor(GM CSF) in autologous peripheral blood stem cells(APBSC) mobilization.Methods The mobilization regimen:CBP 350?mg/m 2 intravenously injected at day 1,Vp16 350?mg/m 2 intravenously injected from day 1 to day 3.G CSF and GM CSF 5?μg·kg 1 ·d 1 each,subcutaneously injected and DXM 5?mg/d intramuscularly injected,from the day of white blood cell(WBC) recovery to (2.4~6.4)×10 9/L from nadir to the day before the end of APBSC harvesting.APBSC harvesting started when WBC>20.0×10 9/L and ended when accumulated mononuclear cells (MNC)>5×10 8/kg.CFU GM assay and CD 34 + cells counting of the APBSC were performed.Results Twenty cases underwent APBSC mobilization.APBSC harvest began at day 22.15±3.66 for two successive days.Accumulated MNC was (5.93±1.62)×10 8/kg,CD 34 + cells (23.10±11.53)×10 6/kg and CFU GM (3.44±2.85)×10 5/kg.No severe toxicity was observed.Hematopoiesis was well reconstituted in 8 patients received single and in 1 patient received double APBSC transplantations.Conclusion Chemotherapy combined with G CSF+GM CSF was a safe and highly effective method for APBSC mobilization.

【基金】 国家“九五”攻关课题基金! ( 96 90 6 0 1 12 )
  • 【文献出处】 中华血液学杂志 ,CHINESE JOURNAL OF HEMATOLOGY , 编辑部邮箱 ,2000年05期
  • 【分类号】R730.53
  • 【被引频次】8
  • 【下载频次】109
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