粒细胞集落刺激因子对骨髓移植及外周血干细胞保护的骨髓造血重建

Bone marrow hematopoietic reconstruction of the patients with bone marrow transplantation and peripheral blood progenitor cells support by G CSF

目的：研究粒细胞集落刺激因子（Ｇ－ＣＳＦ）对骨髓移植及外周血造血干细胞保护患者的骨髓造血重建中的作用。方法：采用自体／异基因骨髓移植和外周血造血祖细胞保护的大剂量化疗，对１１例急性白血病及中－高恶性度非何杰金淋巴瘤患者进行治疗。骨髓或外周血造血祖细胞回输后，开始使用粒细胞集落刺激因子（Ｇ－ＣＳＦ）２．５～５μｇ／ｋｇ，１次／日。停用Ｇ－ＣＳＦ后，对骨髓及外周血进行ＣＦＵ－ＧＭ，ＢＦＵ－Ｅ，ＣＦＵ－ｍｉｘ培养和ＣＤ３４＋ＣＤ３８＋、ＣＤ３４＋ＣＤ３８－细胞检测。结果：Ｇ－ＣＳＦ使用天数分别为：ＰＢＳＣＴ组１１±２ｄ；ＡＢＭＴ组１８±２ｄ；ａｌｏ－ＢＭＴ组２０±２ｄ。骨髓涂片显示：骨髓增生活跃。外周血象恢复时间缩短，骨髓及外周血ＣＦＵ－ＧＭ，ＢＦＵ－Ｅ，ＣＦＵ－ｍｉｘ培养和ＣＤ３４＋ＣＤ３８＋、ＣＤ３４＋ＣＤ３８－细胞检测表明造血祖细胞恢复良好。结论：Ｇ－ＣＳＦ能促进骨髓造血重建，缩短骨髓空虚期，减少严重感染的发生。

Objective: To explore the effect of bone marrow hematopoietic reconstruction of patients with bone marrow transplantation and peripheral blood progenitor cells supported by granulocyte colony stimulating factor (G CSF). Methods: Eleven patients with acute leukemia or intermediate and high grade non Hodgkin's lymphoma received autologous/allogeneic bone marrow transplantation (BMT) or high dose chemotherapy supported by peripheral blood progenitor cells (PBPC). G CSF was begun to use at the dose of 2.5～5 μg/(kg·day) after the bone marrow or the peripheral blood progenitor cells were reinfused. The colony assays of CFU GM, BFU E, CFU mix, and measurement of CD34+CD38+ cells and CD34+CD38 cells in bone marrow and in peripheral blood were done after G CSF administration was stoped. Results: The time for G CSF usage was 11±2 days in the patients with PBPC support, 18±2 days in autologous BMT and 20±2 days in allogeneic BMT. Bone marrow smear showed hypercellularity especially in granulocyte. Recovery time for peripheral blood routine was short. The assays of CFU GM, BFU E, CFU mix, CD34+CD38+ cells and CD34+CD38- cells in bone marrow and in peripheral blood confirmed that the hematopoietic cells recovered well. Conciusion: The result suggests that G CSF can promote hematopoietic reconstruction, shorten the empty time of bone marrow and reduce the chance of sever infection after BMT and PBPC rescue.