Application of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF) for the prevention of neutropenia in triple negative breast cancer patients older than 65 years during adjuvant chemotherapy

Objective The aim of this study was to compare the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)and recombinant human granulocyte colonystimulating factor(rhG-CSF)for the prevention of neutropenia in elderly breast cancer patients during adjuvant chemotherapy.Methods A total of 45 oncology inpatients with breast cancer,who received adjuvant chemotherapy and were older than 65 years from May 2017 to October 2018 in the General Hospital of the Northern Theater of the Chinese people’s Liberation Army,were included.Epirubivin Cyclophoshamide-Docetaxel(EC-T)sequential adjuvant chemotherapy was chosen.Forty-five patients were randomly divided into two groups;25 patients in the treatment group were treated with PEG-rhG-CSF and 20 patients in the control group were not treated with PEG-rhG-CSF,but only rhG-CSF.The experimental group was treated with the PEG-rhG-CSF at the end of chemotherapy for 24–48 h,with a 6 mg subcutaneous injection once per chemotherapy cycle.In the control group,rhG-CSF was administered after 48 h of chemotherapy,with a 100μg subcutaneous injection,1/d,d 1–7.The dosage could be increased step by step with the exacerbation of neutropenia.The primary aims of this study was to discover the incidence of leukopenia,neutropenia,neutrophilic fever,and adverse reactions in the two groups.Results The incidence of neutropenia,neutrophilic fever and adverse reactions decreased in the treatment group compared to the control group,but no significant difference existed between two groups(P>0.05).Patients in treatment group had a lower,but not statistically significant,incidence of adverse reactions(P>0.05).Conclusion Applying PEG-rhG-CSF could be effective in preventing neutropenia in elderly patients with postoperative adjuvant chemotherapy to treat breast cancer.It may effectively control the occurrence of neutropenia after chemotherapy and reduce the chance of infection.The incidence of side effects,such as fever and bone pain,was low.The adverse drug reactions were well tolerated by patients,which could ensure the smooth progress of chemotherapy.

Anti-apoptotic effects of recombinant human granulocyte colony-stimulating factor in focal cerebral ischemic rats

The neuroprotective effects of granulocyte colony-stimulating factor in cerebral ischemia/reperfusion injury are currently contentious. The present study examined the effects of subcutaneous injection of recombinant human granulocyte colony-stimulating factor （50 pg/kg） over 5 days in a model of cerebral ischemia/reperfusion with intraluminal filament occlusion in rats. The results indicated that recombinant human granulocyte colony-stimulating factor reduced brain infarct volume following cerebral ischemia/reperfusion injury in rats, down-regulated the expression of caspase-3 mRNA （a key protease for apoptosis in the cerebral ischemia zone）, lowered the rate of neuronal apoptosis in the cerebral ischemia zone, and notably ameliorated neurological function. These results indicate that recombinant human granulocyte colony-stimulating factor has anti-apoptotic effects on neurons following focal cerebral ischemia/reperfusion injury, and exerts neuroprotective effects.

Refolding with Simultaneous Purification of Recombinant Human Granulocyte Colony-stimulating Factor from Escherichia coli Using Strong Anion Exchange Chromatography

The urea denatured recombinant human granulocyte colony-stimulating factor (rhG- CSF) which was expressed in Escheriachia coli (E. coli) was refolded with simultaneous purification by strong anion exchange chromatography (SAX) in the presence of low concentration- of urea. The effect of urea concentration on this refolding process was investigated. The obtained refolded rhG-CSF has a high specific activity of 2.3×108 U/mg, demonstrating that the proteins were completely refolded during the chromatographic process. With only one step by SAX in 40 min, purity and mass recovery of the refolded and purified rhG-CSF were 97% and 43%, respectively.

A New Protocol for Solubilization, Refolding and Purification of Recombinant Human Granulocyte Colony-stimulating Factor in Inclusion Bodies

Recombinant human granulocyte colony-stimulating factor （rhG-CSF） in inclusion bodies was solubilized by 8 mol/L urea solution and subsequently precipitated by acetone to improve its purity. After that, the precipitates were solubilized by sodium hydroxide solution containing 2 mol/L urea. Then the solubilized rhG-CSF was passed through a size exclusion chromatography for refolding and extensive purification, and further purified by a weak anion exchange chromatography. The purity and mass recovery of refolded rhG-CSF were 96.5% and 75.6%, respectively. The bioactivity was 8.4x10^7 IU/mg.

CONSTRUCTION OF EUKARYOTIC EXPRESSION VECTOR WITH GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR GENE

Objective: To construct the eukaryotic expression vector that express human granulocyte-macrophage colony-stimulating factor (hGM-CSF) gene for making highly express in mammalian cells. Methods: Extract totally RNA from the induced human fetal lung (HFL) cell line. HGM-CSF cDNA was obtained by reverse transcription-polymerase chain reaction (RT-PCR), and then directionally subcloned into the HindIII and EcoRI site on the pcDNA3.1 plasmid, which was controlled by the CMV promoter, to form the recombinant expressing vector pcDNA3.1-GM-CSF. Results: The PCR amplification was identified and the sequence was analyzed, the results showed that hGM-CSF was properly inserted into the vector and the sequence was correct.

Pharmacokinetics of recombinant human granulocyte macrophage colony-stimulating factor in Macaca mulata

目的：研究重组人粒细胞巨噬细胞集落刺激因子（ｒｈＧＭＣＳＦ）在恒河猴体内的药物动力学．方法：用酶连接免疫吸附测定法检测血浆中ｒｈＧＭＣＳＦ的含量．结果：ｉｖｒｈＧＭＣＳＦ后血药浓度时间曲线符合三房室模型．第１，２和３相的Ｔ１２分别为００５－００７ｈ，０１４－０５８ｈ和１４－４１ｈ．ＡＵＣ随剂量成比例增加．ｉｖ高剂量和低剂量的Ｃｌ和Ｋ１０都相似．ｓｃｒｈＧＭＣＳＦ后血药浓度的峰值为０９３±０１６μｇ·Ｌ－１，达峰时间为２６５±０１４ｈ，生物利用度为０６１．结论：恒河猴ｒｈＧＭＣＳＦ药物动力学数据为临床试验提供有用参考．

A pilot study on the combined therapy of granulocyte-macrophage colony-stimulating factor and hepatitis B vaccine on chronic hepatitis B virus carrier children

Objective To observe the efficacy of treating intrauterine infected chronic hepatitis B virus (HBV) carrier children with a combination of granulocyte macrophage colony stimulating factor (GM CSF) or hepatitis B immunoglobulin (HBIG) plus recombinant hepatitis B vaccine (rHBvac) Methods A total of 27 chronic HBV infected children, who were born to HBV carrier mothers and received hepatitis B immunoprophylaxis at birth, were randomized into 2 groups: one receiving a combined therapy of 50 μg of GM CSF plus 10 μg of rHBvac injected intramuscularly at the same location (GM CSF group, 14 children) or 200 IU HBIG and 10 μg rHBvac in different muscles (HBIG group, 13 children) on a monthly four dose schedule HBV DNA quantification and other HBV serological markers were tested before and after the four dose therapy Results Twelve children in each group completed the study Of them, 3 children in the GM CSF group and 4 in the HBIG group had elevated serum alanine transaminase (ALT) before the trial, and then 2 in each group became ALT normal after the treatment Before the therapy, hepatitis B e antigen (HBeAg) positivity was found in nine children in the GM CSF group and 10 in the HBIG group One from each group had an HBeAg/anti HBe seroconversion after the treatment The quantity of HBV DNA was significantly lower after the treatment ( P =0 023) in GM CSF group, but was not significantly reduced in HBIG group No subjects were found to be negative for hepatitis B surface antigen (HBsAg) after the treatment, and no serious adverse events occurred in either group Conclusion Combined GM CSF and rHBvac therapy inhibit HBV replication in carrier children who were not protected after treatment with immunoprophylaxis

rhG-CSF在治疗儿童化疗性口腔黏膜炎中的应用研究

目的探究重组人粒细胞集落刺激因子(recombinant human granulocyte-colony stimulating factor,rhG-CSF)在治疗儿童化疗性口腔黏膜炎中的应用效果。方法选取2020年1月至2022年6月于笔者医院肿瘤外科化疗的60例化疗性口腔黏膜炎患儿,按随机数字表法分为两组,每组30例。对照组采取生理盐水口腔护理,实验组采取rhG-CSF口腔护理。比较两组患儿干预效果、口腔黏膜炎分度、生存质量[健康状况调查简表(36-item short—form,SF-36)]、患儿家长护理满意度。结果实验组总有效率较对照组高,差异有统计学意义(P<0.05)。干预5d,实验组患儿口腔黏膜炎分度结果优于对照组,差异有统计学意义(P<0.05)。干预5d,两组患儿SF-36评分较干预前高,实验组较对照组高,差异有统计学意义(P<0.05)。实验组患儿家长满意度较对照组高,差异有统计学意义(P<0.05)。结论rhG-CSF口腔护理可有效提高儿童化疗性口腔黏膜炎的干预效果,减轻口腔黏膜炎分度,改善患儿生存质量,提高患儿家长护理满意度。

Granulocyte Colony-stimulating Factor-primed Bone Marrow： An Excellent Stem-cell Source for Transplantation in Acute Myelocytic Leukemia and Chronic Myelocytic Leukemia

Background：Steady-state bone marrow （SS-BM） and granulocyte colony-stimulating growth factor-primed BM/peripheral blood stem-cell （G-BM/G-PBSC） are the main stem-cell sources used in allogeneic hematopoietic stem-cell transplantation.Here,we evaluated the treatment effects of SS-BM and G-BM/G-PBSC in human leucocyte antigen （HLA）-identical sibling transplantation.Methods：A total of 226 patients （acute myelogenous leukemia-complete remission 1,chronic myelogenous leukemia-chronic phase 1） received SS-BM,G-BM,or G-PBSC from an HLA-identical sibling.Clinical outcomes （graft-versus-host disease [GVHD],overall survival,transplant-related mortality [TRM],and leukemia-free survival [LFS]） were analyzed.Results：When compared to SS-BM,G-BM gave faster recovery time to neutrophil or platelet （P 〈 0.05）.Incidence of grade Ⅲ-Ⅳ acute GVHD and extensive chronic GVHD （cGVHD） was lower than seen with SS-BM （P 〈 0.05） and similar to G-PBSC.Although the incidence of cGVHD in the G-BM group was similar to SS-BM,both were lower than G-PBSC （P 〈 0.05）.G-BM and G-PBSC exhibited similar survival,LFS,and TRM,but were significantly different from SS-BM （P 〈 0.05）.There were no significant differences in leukemia relapse rates among the groups （P 〉 0.05）.Conclusions：G-CSF-primed bone marrow shared the advantages of G-PBSC and SS-BM.We conclude that G-BM is an excellent stem-cell source that may be preferable to G-PBSC or SS-BM in patients receiving HLA-identical sibling hematopoietic stem-cell transplantation.

PEG-rhG-CSF与rhG-CSF预防肿瘤化疗相关中性粒细胞减少的有效性和安全性比较的系统评价和Meta分析

目的:比较聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)与重组人粒细胞集落刺激因子(rhG-CSF)预防肿瘤化疗相关中性粒细胞减少的有效性和安全性。方法:检索PubMed、Embase、the Cochrane Library、中国知网、万方数据库和维普数据库,纳入PEG-rhG-CSF与rhG-CSF预防肿瘤化疗相关中性粒细胞减少(CIN)的随机对照试验(干预措施为使用PEG-rhG-CSF;对照措施为使用rhG-CSF),检索时间截至2023年5月。文献筛选和信息提取由2名研究者独立完成,并进行偏倚风险评估。采用RevMan 5.3统计软件对提取的数据进行Meta分析。结果:共纳入41篇文献。Meta分析结果显示,与rhG-CSF比较,PEG-rhG-CSF可以显著降低化疗后中性粒细胞减少伴发热(FN)发生率(OR=0.64,95%CI=0.51~0.81,P=0.0002)和Ⅲ/Ⅳ度中性粒细胞减少发生率(OR=0.49,95%CI=0.35~0.69,P<0.0001),差异均有统计学意义,但Ⅲ/Ⅳ度中性粒细胞减少持续时间(MD=-0.33,95%CI=-0.68~0.01,P=0.06)、中性粒细胞减少恢复时间(MD=-0.11,95%CI=-0.32~0.09,P=0.27)、骨痛或骨骼肌肉痛发生率(OR=0.81,95%CI=0.66~1.00,P=0.05)的差异均无统计学意义。结论:PEG-rhG-CSF预防化疗后FN及Ⅲ/Ⅳ度中性粒细胞减少的有效性明显优于rhG-CSF,PEG-rhG-CSF作为一级预防具有可行性。

PEG-rhG-CSF在血液肿瘤自体造血干细胞动员中的临床分析

目的:探讨无外周血CD34监测下聚乙二醇重组人粒细胞集落刺激因子(PEG-rhG-CSF)在血液肿瘤自体外周血干细胞动员中的采集时机及采集效果。方法:回顾性分析2017年8月至2022年1月福建医科大学附属第一医院收治的46例行自体外周血干细胞动员的血液恶性肿瘤患者。采用大剂量化疗联合PEG-rhG-CSF或重组人粒细胞集落刺激因子(G-CSF)动员方案,其中应用PEG-rhG-CSF动员的27例(PEG-rhG-CSF组),应用G-CSF动员的19例(G-CSF组),比较两组患者动员采集效果。结果:46例患者共采集86例次,PEG-rhG-CSF组与G-CSF组获得采集物的单个核细胞中位数分别为6.54(3.85-12.61)×10^(8)/kg和6.15(1.13-11.58)×10^(8)/kg(P>0.05),采集物CD34^(+)细胞数分别为11.44(1.33-65.02)×10^(6)/kg和4.95(0.30-24.02)×10^(6)/kg(P<0.05),采集时机分别为14(10-20)和14(4-22)d(P>0.05)。PEG-rhG-CSF组在外周血白细胞(WBC)≥10×10^(9)/L时单次所采集的产物CD34^(+)细胞数明显高于外周血WBC<10×10^(9)/L时采集的数量[19.04(2.85-65.02)×10^(6)/kg vs 6.22(0.81-34.86)×10^(6)/kg,(P<0.05)]。结论:采用PEG-rhG-CSF动员外周血干细胞单次采集足量CD34^(+)细胞成功率高,中位动员时间为14 d;在无外周血CD34监测情况下,外周血WBC≥10×10^(9)/L可以考虑作为单次采集足量干细胞的采集阈值。

基于加权TOPSIS法的PEG-rhG-CSF合理性评价

目的建立聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)合理性使用的评价标准,利用加权优劣解距离法(TOPSIS)对PEG-rhG-CSF进行评价,为临床合理使用提供参考依据。方法调取福州市第二医院2019年10月至2022年4月的出院病历,以PEG-rhG-CSF说明书为基础,参照相关指南、专家共识以及文献资料制订评价标准,采用加权TOPSIS法进行合理性评价。结果使用PEG-rhG-CSF的426份病历中,理想解相对接近度(C_(i))>80%共250例(占比58.69%),介于60%~80%的124例(占比29.11%),<60%的52例(占比12.21%)。主要不合理使用问题表现在适应证不适宜、给药时机不适宜、药物联用不适宜。结论基于TOPSIS法的合理性评价,综合考虑多个指标,可以反映药物使用过程中各个环节的使用情况,评价过程简便灵活,操作性强。评价结果显示福州市第二医院PEG-rhG-CSF的临床应用过程基本合理,但需要加大管理的力度,保证临床合理使用该类药物。

PEG-rhG-CSF预防小细胞肺癌化疗后中性粒细胞减少症的效果分析

目的:探讨聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)预防小细胞肺癌化疗后中性粒细胞减少症的效果。方法:选取2020年1月—2023年3月北京市朝阳区桓兴肿瘤医院收治的小细胞肺癌化疗患者200例,按照信封法分为两组。对照组(n=98)化疗后应用重组人粒细胞刺激因子(rhGCSF),观察组(n=102)化疗后应用PEG-rhG-CSF。比较两组中性粒细胞减少症发生率、免疫功能、血清肿瘤标志物水平及不良反应发生情况。结果:观察组中性粒细胞减少症发生率低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组CD3^(+)、CD4^(+)水平均高于对照组,CD8^(+)及细胞角质蛋白19片段(Cyfra21-1)、胃泌素释放肽前体(Pro-GRP)、神经元特异性烯醇化酶(NSE)水平均低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:小细胞肺癌化疗后应用PEG-rhG-CSF能有效预防中性粒细胞减少症的发生,改善机体免疫功能,抑制血清肿瘤标志物水平,且安全性良好。

经完全性手术切除的Ⅱ~ⅢA期EGFR野生型NSCLC术后辅助化疗中预防应用PEG-rhG-CSF的临床获益分析

目的探究经完全性手术切除的Ⅱ~ⅢA期表皮生长因子受体(EGFR)野生型非小细胞肺癌(NSCLC)术后辅助化疗中预防应用聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)的临床获益。方法前瞻性选取2019年2月至2021年2月广东医科大学附属医院经完全性手术切除的Ⅱ~ⅢA期EGFR野生型NSCLC术后辅助化疗患者90例作为研究对象,根据随机数字表法将患者分为观察组与对照组,每组各45例。对照组预防性应用重组人粒细胞(rhG-CSF),观察组预防性应用PEG-rhG-CSF。对患者随访3个月,比较两组治疗前及治疗1、3、5、10 d后的白细胞计数、中性粒细胞计数水平及白细胞减少症、中性粒细胞减少症发生情况,并记录患者随访期内化疗后的不良反应情况。结果两组患者在治疗前及治疗1、3、5 d后的白细胞计数水平比较,差异均无统计学意义(P>0.05);治疗10 d后,观察组患者的白细胞计数水平为(5.65±1.11)×10^(9)/L,高于对照组[(4.66±1.08)×10^(9)/L],差异有统计学意义(P<0.05)。两组患者在治疗前及治疗1、3、5 d后的中性粒细胞计数水平比较,差异均无统计学意义(P>0.05);治疗10 d后,观察组患者的中性粒细胞计数水平为(3.61±1.51)×10^(9)/L,高于对照组[(2.65±1.46)×10^(9)/L],差异有统计学意义(P<0.05)。观察组患者2、3级白细胞减少症和中性粒细胞减少症发生率分别为15.56%、11.11%,均低于对照组(35.56%、42.22%),差异均有统计学意义(P<0.05)。两组患者在骨骼肌疼痛、疲劳、感染、发热、胃肠反应等方面比较,差异均无统计学意义(P>0.05)。结论对经完全性手术切除后Ⅱ~ⅢA期EGFR野生型NSCLC患者,术后辅助化疗中预防应用PEG-rhG-CSF可以提高白细胞计数和中性粒细胞计数水平,并减少白细胞减少症和中性粒细胞减少症的发生,有助于改善患者的免疫功能和预后。

四君子汤联合rhG-CSF对卵巢癌患者术后化疗导致白细胞降低的临床效果

目的分析四君子汤联合重组人粒细胞刺激因子注射液(rhG-CSF)对卵巢癌患者术后化疗导致白细胞降低的临床效果。方法选取80例卵巢癌术后化疗导致白细胞降低患者,随机分为对照组(40例)和联合组(40例)。其中对照组给予rhG-CSF治疗,联合组给予四君子汤联合rhG-CSF治疗。比较2组Th1类细胞因子水平[肿瘤坏死因子α(TNF-α)、γ-干扰素(IFN-γ)、白细胞介素-2(IL-2)],Th2类细胞因子水平[白细胞介素-6(IL-6)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)],白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NE),中医证候积分,临床疗效及不良反应发生情况。结果与治疗前比较,2组治疗后血清TNF-α、IL-6、IL-4、IL-10水平、神疲乏力、自汗盗汗、食少纳呆、腰膝酸软等中医证候积分均明显降低(P<0.05),且与对照组比较,观察组明显降低(P<0.05);2组血清IFN-γ、IL-2、WBC、PLT、NE水平明显升高(P<0.05),且与对照组比较,观察组明显升高(P<0.05);观察组总有效率(52.50%)明显高于对照组(30.00%)(P<0.05);观察组不良反应发生率(2.50%)明显低于对照组(20.00%)(P<0.05)。结论四君子汤联合rhG-CSF治疗卵巢癌术后化疗导致白细胞降低患者可有效改善临床症状,升高白细胞水平,提高免疫功能,安全有效。

rhIL-11加rhG-CSF对8.0Gy照射猴的治疗作用

为观察rhIL 11加rhG CSF对极重度骨髓型急性放射病的治疗作用 ,以 8只正常雄性猕猴用60 Coγ射线照射源一次全身照射 8 0Gy(15 0R/min) ,随机分为对照组和治疗组 ,每组 4只动物。治疗组于照射后当天开始 ,连续 2 1天皮下注射rhIL 116 0 μg/(kg·d)加rhG CSF 10 μg/(kg·d) ,并辅以对症支持治疗。结果显示 ,照射后所有动物均出现呕吐、腹泻、发热等临床表现 ,外周血三系细胞均迅速下降。对照组由于严重的出血和感染于照射后 12～ 2 1天相继死亡 ,平均存活时间为 18 2天。治疗组 4只动物照射后 45天全部存活 ,外周血象恢复到接近照射前水平 ,活杀经病理组织学观察表明骨髓造血功能基本恢复。提示rhIL 11加rhG CSF辅以对症治疗对 8

不同剂量rhG-CSF预防晚期非小细胞肺癌化疗后白细胞减少的临床研究

背景与目的:肿瘤化疗最常见的剂量限制性毒性是骨髓抑制,其中白细胞和中性粒细胞减少最为常见。骨髓抑制不但使化疗药物的剂量提高受到限制,而且影响了化疗的正常进行。基因重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimulating factor,rh G-CSF)不仅具有刺激粒细胞集落形成的能力,也有促进粒细胞生长、增殖和分化的能力,对化疗所致白细胞和中性粒细胞减少具有明显疗效。本研究观察晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者接受化疗后预防性应用低、中、高3种不同剂量的rh G-CSF升白效果及不良反应,探讨该药合理的应用策略。方法:126例经病理证实为晚期NSCLC化疗的患者,按数字随机法分为A、B、C共3组。3组患者于化疗结束后24 h给予rh G-CSF。其中A组(低剂量):rh G-CSF300μg,皮下注射,每日1次,共1天;B组(中剂量):rh G-CSF 300μg,皮下注射,每日1次,共2天;C组(高剂量):rh G-CSF 300μg,皮下注射,每日1次,共3天。观察患者用药后出现的症状和体征以及rh G-CSF的不良反应。结果:化疗后预防性使用中、高剂量rh G-CSF可以使近60%的患者白细胞高于4.0×109个/L;对于Ⅲ级白细胞减少的患者,低剂量组白细胞水平回升天数更长,高剂量组白细胞回升天数明显缩短,高剂量组和低剂量组之间差异有统计学意义(P<0.05);从中性粒细胞的动态变化情况来看,化疗后加用高剂量rh G-CSF可以提高中性粒细胞的平均水平,能明显缩短化疗引起中性粒细胞低下的持续时间。126例患者中感染发生率为4.76%,其中低剂量组为9.52%,中剂量组为4.76%。rh G-CSF引起的不良反应轻微,患者能耐受。结论:化疗后预防性使用不同剂量rh G-CSF均可促进化疗患者白细胞和中性粒细胞的恢复,降低感染发生率。在相同化疗剂量下选用高剂量的rh G-CSF可使白细胞和中性粒细胞水平快速上升,安全可靠。

重组人粒细胞集落刺激因子(rhG-CSF)对小细胞肺癌化疗后骨髓抑制的有效性和安全性分析

目的评价重组人粒细胞集落刺激因子(rhG-CSF,造血生长因子)对小细胞肺癌化疗所致骨髓抑制的疗效。方法对解放军总医院2002年至2006年来222例小细胞肺癌患者病例进行回顾性调查,采集其中62例化疗后使用重组人粒细胞集落刺激因子进行治疗的病例,并对信息进行统计学分析。结果重组人粒细胞集落刺激因子可以有效缓解小细胞肺癌患者化疗后的骨髓抑制反应,使白细胞和中性粒细胞数目明显升高,平均恢复时间3天,有效率为95.2%。结论rhG-CSF对治疗小细胞肺癌化疗所致的骨髓抑制作用好,不良反应少;但对不同患者的不同情况,应调整剂量和用法。

中剂量rhG-CSF动员对供者外周血免疫细胞组成的影响

本研究观察12例健康供者在使用10μg/(kg·day)rhGCSF动员前后白细胞总数变化。应用外周血涂片瑞氏染色对白细胞进行形态学分类,使用流式细胞术分析动员前后外周血单个核细胞中T细胞、B细胞、NK细胞和单核细胞比例的变化。结果发现,动员前1天外周血白细胞计数中位数为6.25(4.7-7.8)×109/L,其中淋巴细胞中位数为2.07(1.63-3.1)×109/L,单核细胞中位数为0.163(0.078-0.414)×109/L;动员第5天外周血白细胞计数中位数为37.47(24-72.57)×109/L,其中淋巴细胞中位数为3.22(1.46-5.31)×109/L,单核细胞中位数为1.2(0.706-3.627)×109/L。供者外周血白细胞的增加为动员前的6.26±2.14倍(P<0.01),其中淋巴细胞的增加为动员前的1.45±0.76倍(P<0.05),单核细胞数增加为动员前的7.48±4.41倍(P<0.01)。流式细胞术分析发现,动员前CD3+T淋巴细胞占外周血单个核细胞(PBMNC)比例的中位数为46.96%[(32.36-57.45)%],动员后为40.94%[(25.31-48.9)%];动员前CD4+/CD8+淋巴细胞比例为1.27±0.46,动员后为1.36±0.51;动员前CD4+CD8+T淋巴细胞占PBMNC比例的中位数为0.41%[(0.16-1.51)%],动员后为0.49%[(0.09-2.0)%];动员前CD16+CD56+NK细胞占PBMNC比例的中位数为13.98%[(4.08-25.08)%],动员后为16.65%[(12.06-33.05)%];动员前CD3+CD16+CD56+NK-T细胞占PBMNC比例的中位数为2.75%[(0.37-6.38)%],动员后为3.13%[(0.46-5.95)%];动员前CD20+B淋巴细胞占PBMNC比例的中位数为9.28%[(5.97-16.33)%],动员后为9.94%[(7.36-20.41)%];动员前CD14+单核细胞占PBMNC比例的中位数为12.48%[(3.54-19.35)%],动员后为29.52%[(16.51-36.76)%]。动员后CD14+单核细胞在PBMNC中的比例比动员前增加2.87±1.51倍(P<0.05);动员前后T淋巴细胞、NK细胞、NK-T细胞、B淋巴细胞在PBMNC中的比例以及动员前后CD4+/CD8+淋巴细胞比均无显著变化(P>0.10)。结论:rhGCSF动员引起的单核细胞增加可能在异基因外周血造血干/祖细胞移植的相关事件中发挥着重要作用。

不同剂量rhG-CSF对急性白血病患者化疗后白细胞水平的影响

目的探讨不同剂量重组人粒细胞集落刺激因子(rhG-CSF)对急性白血病患者化疗后白细胞水平的影响。方法选择2014年1月至2017年5月该院收治的64例急性白血病患者为研究对象,根据入院先后顺序随机分为3组,rhG-CSF用量每天为400μg/m^2(高剂量)设为A组,rhG-CSF用量每天为300μg/m^2(中剂量)设为B组,rhG-CSF用量每天为200μg/m^2(低剂量)设为C组,疗程3d。比较3组患者化疗后白细胞最低值(WBC_(min)),最高值(WBC_(max)),白细胞计数(WBC)<4.0×10~9/L的时间即WBC减少时间;并于化疗2周期后使用KPS评分评定患者生存质量,记录应用抗菌药物情况。结果化疗后,3组患者WBC_(min)及WBC_(max)差异无统计学意义(P>0.05);WBC减少时间在A组为(1.73±0.48)d,明显低于B组[(3.35±1.29)d],B组低于C组[(5.84±2.62)d],差异均有统计学意义(P<0.05);3组患者KPS评分比较差异无统计学意义(P>0.05);C组抗菌药物使用率(33.33%)明显高于A组(5.56%)和B组(11.11%),差异均有统计学意义(P<0.05),但是B组与C组间抗菌药物使用率比较,差异无统计学意义(P>0.05)。结论中、高剂量的rhG-CSF可以有效缩短急性白血病化疗患者的白细胞减少期,且中剂量与高等剂量rhG-CSF的治疗效果相当,更值得临床推荐。