儿童恶性肿瘤化疗后小剂量短疗程国产rhG-CSF的应用

Effects of Low Dose and Short-term Domestic Product of rhG-CSF in Postchemotherapeutic Children with Malignancies

目的:观察小剂量短疗程重组人粒细胞集落刺激因子(rhG-CSF)对化疗儿童白细胞(WBC)下降的防治作用。方法:34例恶性肿瘤化疗儿童,采取自身交叉对照的方法,每例同方案化疗3个疗程。其中一个疗程不用rhG-CSF作为对照组;一个疗程化疗结束后48小时起给予小剂量短疗程rhG-CSF3～5μg/kg·d,皮下注射,连用5天,为治疗1组;另一个疗程化疗结束后,WBC<4×109/L时给予同样疗程和剂量的rhG-CSF作为治疗2组。比较各组间WBC及中性粒细胞(ANC)的变化,并观察不良反应。结果:治疗1组和治疗2组WBC下降(<4×109/L)、ANC下降(<2×109/L)持续的天数均低于对照组,但治疗1组的疗效优于治疗2组。WBC和ANC下降的最低值治疗1组高于对照组(P<0.05),而治疗2组与对照组相比无差异。结论:小剂量短疗程国产rhG-CSF的早期应用可以缩短WBC、ANC下降的持续时间及减轻其下降程度,缩短化疗间歇,提高化疗效果。

Objective: To evaluate the effects of low dose and short-term domestic product of rhG-CSF in prevention and treatment of leukopenia caused by chemotherapy in children with malignancies. Methods: 34 children with malignancies were treated with combination chemotherapy. Each patient received three cycles of chemotherapy, namely, two trial cycles and one control cycle. In the control cycle, rhG-CSF was not used. In trail cycle one, rhG-CSF was used 48 hour after chemotherapy. In trial cycle two, rhG-CSF was administrated when white blood cell(WBC)<4×109. The change of WBC and absolute neutrophil count(ANC) between different cycles was compared. Results: The duration of leukopenia and neutropenia in trial cycle one and trial cycle two was shorter than that in control cycle. However, trial cycle one showed better effect in prevention and treatment of leukopenia than that in trial cycle two. The lowest number of WBC and ANC in trial cycle one is higher than that in trial cycle two and control cycle(P<0.05). Conclusions: These results demonstrated that early treatment with low dose and short-term domestic product of rhG-CSF was able to shorten the duration of leukopenia and to alleviate the degree of leukopenia caused by chemotherapy.