小剂量G-CSF治疗急性髓细胞白血病化疗后白细胞减少的临床研究

Clinical Study of Using Low-dose G-CSF for Leukocytopeniain Acute Myeloid Leukemia Chemotherapy

目的 :观察小剂量基因重组人粒细胞集落刺激因子 (G CSF)对初治急性髓细胞白血病 (AML)化疗后白细胞减少的治疗效果及毒副作用。方法 :对AML化疗后外周血白细胞数低于 1.0× 10 91.5× 10 9·L-1时 ,每日皮下注射G CSF 75 μg ,至连续两次外周血白细胞数大于 3.5× 10 9·L-1时停药。结果 :治疗组外周血白细胞数减少的持续时间 (12 .9± 4 .6 )d ,明显低于对照组 (2 3.3± 5 .1)d(P <0 .0 1) ,感染发生率、严重感染明显减少 ,感染发热的持续时间缩短。G CSF的主要副作用为流感样症状伴低热及肌肉酸痛 ,未发现与应用G CSF相关的恶性细胞增殖现象。结论 :小剂量G CSF对治疗初治的AML化疗后白细胞减少安全有效。

Objective: To study the effect of low-dose granulocyte colony stimulating factor(G-CSF) on leukocytopenia in acute myeloid leukemia (AML) chemotherapy. Methods: Low-dose G-CSF (75 μg·d -1 , hypodermic injection) was used in 38 patients with AML in chemotherapy, started after chemotherapy-induced white blood cell (WBC)<1.0~1.5×10 9 ·L -1 and ended while WBC >3.5×10 9 · L -1 successive two times. Results: Low-dose G-CSF could increase granulocyte rapidly. The average time to WBC <3.5×10 9 ·L was (12.9±4.6) days in study group versus ( 23.3±5.1) days in control group for AML. The administration of G-CSF decreased infectious rate and lessened bad infections, and the total duration of infections was significantly reduced from 9.2 to 4.4 days (P<0.01). Clinical side effects possibly related to G-CSF were not obvious. Conclusion: It could markedly increase granulocyte and shorten duration of infections when low-dose G-CSF was administered after chemotherapy.