格拉诺赛特与化疗药物联合动员自体外周血干细胞的临床研究

Mobilization of Autologous Peripheral Blood Stem Cells by Chemotherapy and Granulocyte(Recombinant Human Granulocyte Colony-stimulating Factor)

  • 摘要: 目的:观察格拉诺赛特联合化疗对恶性实体瘤患者自体外周血造血干细胞(APBSC)的动员效果。方法:32例患者进入本研究,其中恶性淋巴瘤18例,乳腺癌11例,生殖细胞肿瘤3例。自化疗后白细胞降至最低点时开始皮下注射格拉诺赛特150~250μg/day1,至APBSC采集结束前一天,白细胞恢复到5.0×109/L以上时开始连日采集APBSC;当累计采集的单核细胞≥5.0×108/kg或CD34+细胞≥2.0×106/kg时停止采集。结果:开始给予格拉诺赛特及开始采集APBSC的中位时间分别为化疗开始后的第12(5~15)天和第15(13~20)天,格拉诺赛特的中位给药次数为5(3~12)次,全组患者平均采集到的单核细胞及CD34+细胞总数分别为5.76±2.05×108/kg和15.58±10.36×106/kg,平均粒-单集落形成单位21.01±20.75×104/kg。动员过程中不良反应轻微,此后30例接受移植者全部获得造血功能重建。结论:格拉诺赛特联合化疗是一种安全、有效的APBSC的动员方法,国人采用150~250μg/day1的剂量即可得到满意的动员效果。

     

    Abstract: Objective : To observe the effect of Granulocyte (recombinant human granulocyte colony-stimulating factor) and chemotherapy on autologous peripheral blood stem cells (APBSC) mobilization of patients with malignant solid tumors. Methods : This study includes 32 patients with solid tumor (malignant lymphoma 18, breast cancer 11 and germ cell tumors 3). The Granulocyte (Chugai Pharmaceutical Co, Ltd ) was given as a daily injecting subcutanously at the dose of 150~250μg body-1 day-1 from the day of the nadir of white blood cell (WBC) to the day before the end of APBSC harvest.APBSC apheresis was performed when WBC ≥5.0x109 /L from the nadir and finished when accumulated MNC ≥5 x108/kg or CD34+ cells count ≥2x106/kg. Results : The median beginning time of Granulocyte given and apheresis was the day 12(5~15) and the day 16(13~20) from the begin of chemotherapy respectively. The median times of Granulocyte given was 5 (4~12). The total count of M N C and CD34+ cells harvested for each patient were 5.76 ±2.05 x108/kg and 15.58 ±10.36x106/kg, respectively. Colony forming ability of PBSC were done and the mean CFU-GM was 21.01±20.75x104 /kg. A few side effects were observed in the mobilization. All 30 patients who underwent APBscT achieved hematopoiesis recovery. Conclusion : Granulocyte combining with chemotherapy was a safe and highly effective method for APBSC mobilization. The dose of 150<250μg body-1 day-1 of Granulocyt combining with chemotherapy were suitable for APBSC mobilization in Chinese patients.

     

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