粒单核细胞集落刺激因子在骨髓移植中的应用

APPLICATION OF RECOMBINANT HUMAN GRANULOCYTE-MACROPHAGE COLONY STIMULATING FACTOR FOLLOWING ALLOGENEIC BONE MARROWTRANSPLATATION

报告异基因骨髓移植（ａｌｌｏ－ＢＭＴ）后接受重组人粒单核细胞集落刺激因子（ｒｈＧＭ－ＣＳＦ）的患者２５例。ｒｈＧＭ－ＣＳＦ自骨髓移植后第６天开始静脉持续点滴，用量５μｇ／（ｋｇ·ｄ）连用２０天或用至连续３天粒细胞＞１．０×１０￣９／Ｌ或白细胞＞２．０×１０￣９／Ｌ为止。结果：粒细胞升至０．５×１０￣９／Ｌ及１．０×１０￣９／Ｌ的时间，试用组平均为１７．７天及２０．９天；对照组为２２．８天及２９．８天（Ｐ均＜０．００１）。白细胞升至＞１．０×１０￣９／Ｌ及２．０×１０￣９／Ｌ的时间，试用组平均为１８．３天及２３．０天；对照组平均为２３．８天及３３．３天（Ｐ＜０．００１及０．００５）。两组血小板的回升及输血小板次数均无显著差异。结论是ａｌｌｏ－ＢＭＴ后应用ＧＭＣＳＦ有明显促进白细胞（包括粒细胞）的恢复作用。

he effectiveness of recombinant human granulocyte-macrophage coIony stimu lating factor(rhGM-CSF,Leucomax by Schering-plough)was evaluated in 25 pa-tients with leukemia after al logeneic hi2ne marrow trans-plantation (allo-BMT).rhGM-CSF was administered ata dose of 5μg·kg￣(-1)/d by continuous intravenous infu-sion over 4 hours,starting from day 6 post BMT for 20consecutive days or ending with the WBC≥2×10￣9/L orneutrophil≥1×10￣9 /L for 3 consecutive days, The meandurations for leukocyte to reach greater than 1 × 10￣9/Land 2.0×10￣9/L were 18. 3 and 23.0 days respectively inthe rhGM-CSF-treated group v.s. 23. 8 and 3 3.3 daysin the paired chronological control group(P< 0.00 1 and<0.005 respectively).The neutrophil recovery(>0.5×10￣9 /L and >1.0× 10￣9/L)was also significantly fasterfor the patients given rhGM-CSF(mean durations 17.7and 20.9 days)than that of the control(mean durations22.8 and 29.8 days)(P<0.001).However, no differ-ences were noted in durations for platelets to reachgreater than 2 0 × 10￣9/L or in requirements of plateletconcentrates transfusion between rhGM-CSF-treated pa-tients and controls. No obvious adverse events were not-ed in all patients. It is concluded that rh GMCSF signifi-cantly increases neutrophils and total leukocyte counts inthe early stage after bone marrow transplantation.