大剂量足叶乙甙和G-CSF用于恶性血液病外周血造血干/祖细胞动员

High-dose Etoposide with Granulocyte Colony-stimulating Factor for Mobilization of Autologous Peripheral Blood Stem/Progenitor Cells in Patients with Hematologic Malignancies

为了观察大剂量足叶乙甙(VP16)和粒细胞集落刺激因子(G-CSF)在恶性血液病人动员采集自体外周血造血干/祖细胞的有效性和安全性,对10例恶性血液病患者(多发性骨髓瘤6例,非霍奇金淋巴瘤4例),第1天用足叶乙甙1.6g/m2静脉持续滴注10小时,第3天起给予G-CSF5μg/kg,每日1次,皮下注射,直至采集结束。结果显示:用VP16后平均第11(9-13)天开始外周血造血干/祖细胞单采,获CD34+细胞9.4×106/kg(4.2-17.3×106/kg),每例CD34+细胞>4.0×106/kg。平均采集次数2.6(1-4)次。1例发生口咽黏膜炎、2例尿道炎、咽喉炎。结论:足叶乙甙1.6g/m2和G-CSF5μg/kg是恶性血液病动员采集自体干祖细胞的有效安全方案。

To explore the efficacy and safety of high-dose of etoposide with granulocyte colony-stimulating factor （G-CSF） for mobilization of peripheral blood stem cells, 10 patients with hematologic malignancies including 6 patients with multiple myeloma and 4 with non Hodgkin＇s lymphoma received an etoposide dose of 1.6 g/m^2. The total close of undiluted etopogde was given on day 1 as a continuous intravenous infusion via a central vein for 10 hours. G-CSF 5 μg/kg was used on day 3 and given daily subcutaneously until leukopheresis was completed. The results showed that leukopheresis was started at days 11 （range 9 - 13 days） following etoposide therapy, the mean number of CD34^＋ cells collected in all 10 patients was 9.4 × 10^6/kg （range 4.2-17.3 × 10^6/kg）, by an average of 2.6 leukophereses （range 1 -4） times. Mobilization procedure that produced yields of greater than 4.0 × 10^6/kg were achieved in every patient. Toxicity showed oropharyngeal mucosifis, faucifis and urethritis respectively in 3 patients. It is concluded that high-dose etoposide with G-CSF is an effective and safe mobilizing regimen for autologous peripheral blood stem progenitor cells in patients with hematologic malignancies.