阿糖胞苷、鬼臼乙叉甙联合粒细胞集落刺激因子动员自体外周血干细胞

Mobilization of Autologous Peripheral Blood Stem Cells by Using Ara -C, VP -16 and G - CSF

目的:探讨Ara—C、VP16单用或联合用药加G—CSF动员自身外周血干细胞（APBSC）的效果。方法:5例每天单用Ara-C4g/m2,连用2d;2例每天单用VP—16 500mg/m2,连用4d;2例Ara-C与VP-16联合用药,每天剂量Ara-C1g/m2、Vp-16100mp/m2,连用5d。WBC降至10×109/L左右时加用惠尔血5μg·kg-1·d-1至采集结束。CD34+细胞/MNC>1％时用CS3000 plus血细胞分离机采集APBSC。结果:CD34+细胞/MNC持续超过1％的平均时间为≥5.1d,9例单次采集即获得CD34+26.6×106/kg,无严重不良反应。结论:Ara—C、VP16单用或联合用药加粒细胞集落刺激因子动员自身外周血干细胞的动员效率高,且安全,单次采集所获得造血干细胞的量可满足移植所需。

Objective: To observe the efficacy of Ara - C or VP - 16 as a single agent or Ara - C plus VP - 16 followed by G -CSF in the mobilization of autologous peripheral blood stem cells(APBSC). Methods: The mobilization regimens were: 5 cases mobilization chemotherapy consisted of high dose Ara - C 4g/m2 daily for 2 days; 2 cases were mobilized with VP - 16 500mg/m2 daily for 5 days; another 2 cases were mobilized with Ara - C 1.0g/m2 plus VP - 16 100mg/m2 daily for 5 days. G -CSF 5μg·kg-1·d-1 were given on the day when WBC decreased to 1.0×109/L after chemotherapy till the end of APBSC harvesting. Leukapheresis usually started with blood cell separator Baxter 3000 Plus when CD34+cells/MNC reached 1%. Results: CD34+ cells/MNC>1% lasted for more than 5. 1days. The yield of CD34+ cells collected by only one leukaphere-sis was 26.6×106/kg in 9 patients. No severe toxicity was observed. Conclusion: Using Ara-C or VP-16 as a single agent or Ara-C plus VP-16 followed by G - CSF was highly effective and safe in the mobilization of APBSC.