化疗加G-CSF和GM-CSF联合动员自体外周血干细胞

Mobilization of autologous peripheral blood stem cells by chemotherapy and recombinant granulocyte colony stimulating factor(G-CSF) and granulocyte macrophage colony stimulating factor(GM-CSF)

目的 探讨化疗加粒细胞集落刺激因子 (G CSF)和粒 巨噬细胞集落刺激因子 (GM CSF)联合动员自体外周血干细胞 (APBSC)的效果。方法 卡铂 (CBP) 35 0mg m2 ,第 1天静滴 ;足叶乙甙(Vp16 ) 35 0mg m2 ,第 1～第 3天静滴 ;白细胞降至最低点又回升到 (2 .4～ 6 .4)× 10 9 L时 ,皮下注射G CSF 5 μg·kg- 1 ·d- 1 (早 6∶0 0 ) +GM CSF 5 μg·kg- 1 ·d- 1 (晚 6∶0 0 ) +地塞米松 5mg d(采集日 10mg d)直到采集结束前 1天 ;白细胞上升到 (2 9.80± 5 .98)× 10 9 L ,开始用CS30 0 0plus血细胞分离机连续 2d采集APBSC。结果 2 0例患者连续采集APBSC 2次 ,共采集到MNC(5 .93± 1.6 2 )× 10 8 kg ,CD34+ 细胞 (2 3.10± 11.5 3)× 10 6 kg ,CFU GM(3.44± 2 .85 )× 10 5 kg。无严重不良反应。 9例 10次自体外周血干细胞移植(APBSCT)造血功能均获满意重建。结论 以化疗联合G CSF和GM CSF能高效、安全地动员APBSC ,1次动员采集 2次可满足 1～ 2次的APBSCT。

Objective To observe the efficacy of chemotherapy and recombinant granulocyte colony stimulating factor(G CSF,Glycosylated)and granulocyte macrophage colony stimulating factor(GM CSF) in autologous peripheral blood stem cells(APBSC) mobilization.Methods The mobilization regimen:CBP 350?mg/m 2 intravenously injected at day 1,Vp16 350?mg/m 2 intravenously injected from day 1 to day 3.G CSF and GM CSF 5?μg·kg 1 ·d 1 each,subcutaneously injected and DXM 5?mg/d intramuscularly injected,from the day of white blood cell(WBC) recovery to (2.4～6.4)×10 9/L from nadir to the day before the end of APBSC harvesting.APBSC harvesting started when WBC>20.0×10 9/L and ended when accumulated mononuclear cells (MNC)>5×10 8/kg.CFU GM assay and CD 34 + cells counting of the APBSC were performed.Results Twenty cases underwent APBSC mobilization.APBSC harvest began at day 22.15±3.66 for two successive days.Accumulated MNC was (5.93±1.62)×10 8/kg,CD 34 + cells (23.10±11.53)×10 6/kg and CFU GM (3.44±2.85)×10 5/kg.No severe toxicity was observed.Hematopoiesis was well reconstituted in 8 patients received single and in 1 patient received double APBSC transplantations.Conclusion Chemotherapy combined with G CSF+GM CSF was a safe and highly effective method for APBSC mobilization.