rhG-CSF促进急性白血病和恶性淋巴瘤化疗后中性粒细胞恢复的研究

rhG CSF ACCELERATED NEUTROPHIL RECOVERY IN AL AND NHL PATIENTS UNDERGOING CHEMOTHERAPY

目的观察基因重组人粒细胞集落刺激因子对急性白血病和恶性淋巴瘤化疗后中性粒细胞减少的治疗效果及毒副作用。方法采用随机双盲自身对照法，研究ＡＬ２１例和ＮＨＬ１３例共３４例５５个疗程次。在联合化疗４８ｈ后使用格拉诺赛特１００μｇ／ｄ×１４ｄ预防ＡＮＣ减少／缺乏并促进其恢复。结果ＡＮＬＬ和ＮＨＬ给药周期比对照组ＡＮＣ减少／缺乏的时期均明显缩短（ＡＮＣ减少期分别由２１．３ｄ和１５．４ｄ缩短到１０．５ｄ和８．２ｄ，ＡＮＣ缺乏由１１．９ｄ和７．８ｄ缩短到６．３ｄ和４．５ｄ），给药周期的感染率和发热期也短于对照周期。格拉诺赛特的毒副作用发生率是５／５５（１０％），未发现促进ＡＮＬＬ恶性细胞增殖现象，３４例５５个疗程次均耐受了全部治疗过程。结论ｒｈＧ－ＣＳＦ及其类似的造血刺激因子可刺激造血干细胞及粒细胞的分化和增殖，促进中性粒细胞的释放和提高细胞的吞噬功能，这有助于ＡＮＬＬ和ＮＨＬ强烈联合化疗后粒细胞减少／缺乏的预防。

Objective To study rhG CSF acceleration nutrophil recovery in AL and NHL patients undergoing chemotherapy. Methods A randomized double cross self comparison study in 21 patients with ANLL CR(30 course) and 11 NHL plus 2 ALL(25 courses) to assess the value of rhG CSF (Granocyte, Chugai Co Ltd of Japan) in the acceleration of neutrophil recovery following chemotherapy have cendertakem. Dosage of rhG CSF was used with 250 μg s.c. on days 3～14 after cytotoxitydurg or ANC>1.5×10 9/L successive two times. 55 study courses(A) received rhG CSF and 55 control courses (B) no rhG CSF.Results The average time to ANC>0.5×10 9/L was 6.3±5.1 days in study group versus 11.9± 5.0 days in control group for ANLL. The average time to ANC>0.5×10 9/L was 4.5±3.3 days in study gruop versus 7.8±3.4 dsys in control group for NHL. The administration of rhG CSF significantly decreased infectious rate (19/55 to 9/55, P <0.01) and shortened febrile duration each case(6.7 ±1.8) days to (4.1±1.3) days. The rate of advised effect of granocyte was 10% and all of 34 patients tolerated and finished 55 courses. Conclusioin These data suggest that rhG CSF significantly accelerated neutrophil recovery in the patients with hematological malignancies undergoing chemotherapy.