中剂量环磷酰胺联合化疗加粒细胞集落刺激因子对恶性血液病患者自体外周血干细胞的影响

Effect of combined chemotherapy of middle-dose cyclophosphamide plus recombinant human granulocyte colony stimulating factor on autologous peripheral blood stem cells in patients with hematologic malignancies.

目的探讨以中剂量环磷酰胺为主联合化疗加单一剂量重组人粒细胞集落刺激因子(GCSF)对恶性血液病患者自体外周血造血干细胞的动员效果。方法31例患者接受中剂量环磷酰胺2.2g/m2(1.8~3.0g/m2)联合鬼臼乙叉甙(Vp16)600~800mg(CE方案)或阿糖胞苷(AraC)1.0~2.0g/m2(CA方案)化疗。预处理后,予以回输所采自体外周血造血干细胞,观察造血重建情况。结果动员所需时间(化疗开始至采集的平均时间)为(13.5±2.0)d,采集次数为(2.9±1.0)次,WBC最低值为(0.95±1.0)×109/L,GCSF开始给药时间为第(8.6±2.0)天,持续应用平均(7.4±2.0)d,采集到的单个核细胞数为(5.53±2.54)×108/L,CD34+细胞数为(9.46±7.24)×106/L,粒单核细胞集落数为(46.02±70.58)×104/L。全部移植患者造血功能均获满意重建。结论中剂量环磷酰胺为主联合化疗(CE/CA)加单一剂量GCSF对恶性血液病患者的造血干细胞动员是安全和有效的。

Objective To study the effect of combined chemotherapy of middle-dose cyclophosphamide(CTX)plus recombinant human granulocyte colony stimulating factor(G-CSF)on autologous peripheral blood stem cells(APBSC) in patients with hematologic malignancies.Methods 31 patients with hematologic malignancies received CTX 2.2 g/m2(1.8-3.0 g/m2) plus Vp16 (600-800)mg(CE) or Ara-C 1.0-2.0 g/m2(CA) chemotherapy.APBSC was collected for observation of hematopoietic reconstruction.Results The mean time from the beginning of chemotherapy to APBSC collecting was (13.5±2.0) days and the collecting times were 2.9±1.0.The lowest level of WBC was (0.95±1.0)× 109/L.G-CSF was given for (7.4±2.0) days after(8.6±2.0)days treatment until the end of collecting.The mean yield of MNC and CD34+ were (5.53±2.54) ×108/L and ^(9.46±7.24)×106/L ,respectively.CFU-GM was (46.02±70.58) ×104/L.Hematopoietic reconstruction was satisfying in all patients after receiving APBSC transplantation.Conclusion Combined chemotherapy(CE/CA) of middle-dose cyclophosphamide plus single-dose G-CSF for mobilizing autologous peripheral blood stem cells is safe and effective in patients with hematologic malignancies.