皮下注射GM-CSF诱导嗜酸性粒细胞增多患者及相关性分析

Identification of blood eosinophilia induced by subcutaneous administration of GM-CSF

目的探讨皮下注射GM-CSF对外周血嗜酸性粒细胞计数的影响,提高对GM-CSF治疗相关嗜酸性粒细胞增多的认识。方法选取2例血液恶性肿瘤的病例进行分析,患者于化疗后骨髓抑制期给予皮下注射GM-CSF促进中性粒细胞的回复,同时密切监测血常规并观察白细胞及嗜酸性粒细胞计数的变化。结果 GM-CSF应用3～9天后出现外周血嗜酸性粒细胞增多,但不伴有嗜酸性粒细胞增多相关的组织器官损伤,停用GM-CSF后嗜酸性粒细胞计数迅速降至正常,排除其它可致嗜酸性粒细胞增多的原因。结论 GM-CSF治疗可诱导外周血嗜酸性粒细胞增多。临床用药时,应监测嗜酸性粒细胞水平,警惕潜在组织器官损伤可能。

Objective To investigate the effect of subcutaneous administration of GM-CSF on peripheral eosinophil counts and to get a better understanding of eosinophilia associated with GM-CSF therapy. Methods 2 patients with hematological malignancies received subcutaneous administration of GM-CSF after chemotherapy were acceleratee the recovery of neutrophils. A complete blood count was tested biweekly to measure the numbers of white blood cells and eosinophils closely. Results GM-CSF therapy induced eosionophilia in peripheral blood after application for 3 to 9 days, organ damage associated with eosinophilia was not observed. The absolute eosinophil counts returned to normal very quickly once withdrew the stimulating factor. Other possible causes attributable to eosinophilia were excluded. Conclusion GMCSF therapy could induce blood eosionophilia. Ifs advisable to monitor the peripheral eosinophil counts and be on the alert for the potential organ damage during therapeutic application of GM-CSF.