rhG-CSF对老年急性髓性白血病化疗预后的影响

Effects of rhG-CSF on acute myelogenous leukemia after chemotherapy in older patients

目的观察重组人粒细胞集落刺激因子(rhG-CSF)对老年急性髓性白血病(AML)化疗后应用的疗效及时机。方法对2002年1月至2006年6月住院的62例老年急性髓性白血病患者(M3除外),以联合化疗方案诱导缓解治疗后,随机分为3组:G1组(n=20)、G2组(n=18)及非G组(n=24)。G1、G2组接受rhG-CSF治疗,剂量300μg/d,皮下注射:G1组在完成诱导缓解化疗24 h后即开始,G2组在完成诱导缓解化疗后中性粒细胞计数(ANC)<0.5×109/L时开始,2组均在ANC升高至1.5×109/L时停用;非G组不应用rhG-CSF。结果3组临床缓解情况比较,差异无统计学意义(P>0.05)。G1组及G2组粒细胞减少、发生感染的持续时间明显短于非G组(P<0.01)。G1组感染发生率低,与非G组比较,差异有统计学意义(P<0.01);G2组感染发生率与非G组、G1组比较,差异无统计学意义(P>0.05)。结论预防性应用rhG-CSF对于预防、治疗老年AML患者化疗后伴感染、发热是有益的,且早期应用能进一步降低化疗后感染的发生。

Objective To observe the curative effects of recombinant human granulocyte-colony stimulating factor （rhGCSF） on the aged patients with acute myelogenous leukemia （AML） after the chemotherapy. Methocis 62 patients with AML （except M3）, from January 2002 to June 2006, were treated with the joint chemotherapy to induce remission, then were randomly divided into three groups： G1, G2 and Non-G group. Patients in G1 and G2 group were injected with 300μg rhG-CSF a day, injection starting from 24 hours after the chemotherapy for G1 group and from the point of ANC〉0.5×10^9/L for G2 group, and finishing at the point of ANC 〉 1.5 × 10^9/L for both groups. No rhG-CSF was used in Non-G group, glesufts The periods of granulocyte reduction and infection in GI and G2 group were significantly shorter than those in Non-G group （ P 〈 0.05）. The infection incidence in G1 was lower than that of Non-G group （P〈 0.05）. There was no difference of infection incidence between G1 and G2 group, and between G2 and Non-G group （ P 〉 0.05 ）. Concfusion The preventive application of rhG-CSF on the patients with AML leukemia might help to prevent and treat infection and fever after chemotherapy.