升白欣治疗恶性肿瘤化疗所致白细胞减少症51例的临床观察

 作者运用升白欣治疗各种恶性肿瘤化疗所致白细胞减少症51例，采用肌肉注射50u，1/日连用5～7天，结果表明：升白欣可以迅速升高白细胞数，I度和Ⅱ度白细胞减少尤为显著，引例中显效39例，有效8例，总有效率92．2％，与G－csF相比疗效相当。该药升高白细胞后即使停药，亦无白细胞再度降低的现象，且毒副反应小，主要为发热和注射局部疼痛，对症处理多可缓解。     

Polysaccharides isolated from Echinacea purpurea herba cell cultures to counteract undesired effects of chemotherapy--a pilot study

In an open prospective study with matched historical controls we aimed to evaluate whether a polysaccharide fraction isolated from the herb Echinacea purpurea could counteract the undesired effects of chemotherapy. Fifteen patients with advanced gastric cancer undergoing palliative chemotherapy with etoposide, leucovorin and 5-fluorouracil (ELF) received for 10 days (beginning 3 days before chemotherapy) daily i.v. injections of 2 mg of a polysaccharide fraction isolated from Echinacea purpurea herb cell cultures (EPS-EPO VIIa). The median number of leukocytes 14-16 days after chemotherapy was 3630/microL (range 1470-5770) in the patients receiving EPS-EPO VIIa compared with 2370/microL (870-3950) in the patients of the historical control group (p = 0.015). EPS-EPO VIIa had no clinically relevant effects on phagocytic activity of granulocytes or on lymphocyte subpopulations. Sixty-eight adverse events including two deaths were observed, most likely due to chemotherapy and the general condition of the patients. However, an association with the test intervention cannot be ruled out completely. The results of this pilot study suggest that EPS-EPO VIIa might be effective in reducing chemotherapy-induced leukopenia. The efficacy and safety should be investigated in further studies.     

基因重组人粒细胞集落刺激因子在肿瘤大剂量联合化疗中的临床应用研究

目的　观察基因重组人粒细胞集落刺激因子 (rhG CSF)在肿瘤大剂量联合化疗中预防白细胞减少症的疗效。方法　全组病人 16 7例 ,采用自身对照 ,以第一周期为对照周期 ,第二周期为治疗周期 ,在治疗周期末次给药后 48小时起 ,皮下注射rhG CSF 75 μg/d。 结果　化疗后白细胞降低恢复至正常水平以上所需的时间治疗周期显著缩短 (约 11天 ) ,白细胞的下降程度治疗周期显著优于对照周期 ,治疗周期感染的发生率亦显著低于对照周期。结论　rhG CSF的应用可有效预防白细胞减少症的发生及其程度 ,有力支持肿瘤大剂量联合化疗的进行。     

rhG-CSF预防化疗后粒细胞减少的Ⅱ期临床试验

[目的]评价InstitutoSidusS.A.生物公司生产的若美斯(rhG CSF)对防治化疗后粒细胞减少症的作用及不良反应。[方法]采用随机分组的方法 ,将34例患者分为AB组和BA组。AB组第一周期(A周期)化疗48h后加用G CSF ,第二周期为空白对照周期(B周期) ,仅单独使用化疗 ;BA组与上相反。rhG CSF在化疗药物末次给药后48h起 ,5μg/kg,皮下注射 ,每日1次。同时观察患者血中白细胞(WBC)值及中性粒细胞(ANC)值变化。[结果]运用rhG CSF支持后的研究组和对照组相比 ,化疗后WBC值<1×109/L,2×109/L,3×109/L ,4×109/L的持续平均天数明显减少(P<0.05,P<0.01)。ANC值<0.5×109/L,1.0×109/L,1.5×109/L ,2.0×109/L的持续平均天数也明显减少(P<0.05,P<0.01) ,并能减少感染和运用其他抗生素的几率 ,用药后白细胞值及中性粒细胞值在d2 出现第1个高峰、d8 出现第2个高峰。rhG CSF对血小板无明显影响。不良反应表现为 :30%的病人出现轻中度的骨骼肌疼痛 ,6%出现轻度乏力 ,6%出现轻度局部注射痛 ,一般不需特殊处理 ,易于耐受。[结论]rhG CSF可以促进化疗病人WBC和ANC的恢复 ,安全性好 ,可作为化疗提高剂量的辅助用药。     

增白胶囊治疗化疗后白细胞减少症40例

目的：观察增白胶囊对化疗后白细胞减少症的作用。方法：观察组予以增白胶囊治疗,对照组予以鲨肝醇、利血生治疗。结果：观察组 40例,显效 32例,有效 6例,无效 2例。对照组 40例,显效 12例,有效 15例,无效 13例,两组比较有非常显著性差异 (P     

Rapid accurate absolute granulocyte count determination during severe leukopenia using the flow cytometer

The absolute granulocyte count (AGC) in 125 blood samples from patients with total white blood cell counts of less than 1,000/microliter was estimated using three different methods, which were then compared for efficiency and accuracy. The three methods were 25 cell differential counts using Wright's-stained blood smears, granulocyte percentage estimates from WBC counting chambers, and combined narrow- and wide-angle light-scatter characteristics determined on a flow cytometer. A survey of clinical laboratories at University Hospital Cancer Centers revealed that the smear differential was the most-often-used method in those laboratories even when less than 25 cells could be counted. Consequently the data obtained from the counting chamber and flow cytometer methods were compared to the smear differential "standard" using linear regression, and outliers were identified. There was good correlation between AGC determined by smear differential and WBC counting chamber (correlation coefficient .911) and excellent correlation between the AGC determined by smear differential and the flow cytometer method (correlation coefficient .970). The flow cytometer method used in this investigation required minimal specimen preparation, and test results were available at a rate of 60 seconds/sample. The ease of sample preparation, speed, and statistical reliability of test results makes the flow cytometer an attractive alternate method of determining granulocyte counts on leukopenic patients as compared to the stained blood smear differential.     

地黄苷A对环磷酰胺致小鼠白细胞减少症的影响

日的 观察地黄苷A对环磷酰胺致小鼠白细胞减少症的影响。方法 利用环磷酰胺ip造成小鼠白细胞减少症模型,地黄苷A进行治疗,对模型小鼠体重、外周血象、网织红细胞数、脾脏指数、骨髓有核细胞数和DNA含量进行检测。结果 地黄苷A可明显升高模型小鼠的白细胞数、红细胞数、血小板数,网织红细胞数、骨髓有核细胞数和DNA含量及体重,结论 地黄苷A具有明显升白作用。     

Mosaic tetraploidy and transient GFI1 mutation in a patient with severe chronic neutropenia

This report presents the case of a 15-year-old male with severe chronic neutropenia, leukopenia, and persistent tetraploid mosaicism in the bone marrow and peripheral blood. His father had mild neutropenia and bone marrow tetraploidy. Flow cytometric analysis of DNA content peripheral blood showed tetraploidy in 20% of granulocytes and 15% of monocytes. Sequence analysis of the ELA2 gene was normal, but the GFI1 gene exhibited transient appearance of single base changes the coding region and promoter. We speculate that an underlying genetic defect, inherited in an autosomal dominant pattern, leads to both disordered mitosis and neutropenia in this kindred.     

硫普罗宁对环磷酰胺所致小鼠白细胞减少的防治作用

目的 :观察硫普罗宁 (Tiopronin ,MPG)对化疗所致小鼠白细胞减少的预防和治疗作用。方法 :采用环磷酰胺 (CPA)造成小鼠外周血白细胞减少的动物模型 ,观察MPG对由化疗所致白细胞减少的防治作用。结果 :预先用不同剂量MPG给小鼠经口灌胃或腹腔注射 (ig或ip) ,用药 5d ,再腹腔注射 1次CPA ,然后于第 3d计数白细胞总数 ,同时与单用CPA相比差异具有显著性 (P <0 .0 5或P <0 .0 1)。先腹腔注射CPA ,再用不同剂量MPG对小鼠经口灌胃或腹腔注射进行治疗 ,然后于第 3d、第 5d计数白细胞总数 ,与单用CPA组相比差异具有显著性 (P <0 .0 5或P <0 .0 1)。结论 :MPG具有明显的预防和治疗CPA所致的小鼠白细胞减少的作用。     

双黄升白颗粒剂对白细胞减少症模型小鼠造血细胞作用的研究

目的:探讨双黄升白颗粒剂升高白细胞作用及其作用机制。方法:采用Se-137放射源照射ICR小鼠,造成白细胞减少症动物模型,对模型动物给予双黄升白颗粒剂大、中、小剂量(分别为9.2,4.6,2.3 g.kg^-1.d^-1)灌胃,并设正常对照组,模型对照组,阳性对照利可君组。对小鼠外周血象,骨髓有核细胞(BMNC),脾结节(CFU-S)计数,胸腺指数(TI),脾脏指数(SI),骨髓细胞增殖,体外培养小鼠粒单系集落形成单位(CFU-GM),骨髓CD34+细胞比例,骨髓造血微环境等进行检测。结果:双黄升白颗粒可明显升高模型小鼠的白细胞(WBC);双黄升白颗粒可升高模型小鼠的BMNC计数并促进其骨髓细胞增殖;双黄升白颗粒升高模型小鼠CFU-S计数,提高CFU-GM产率,提高骨髓CD34+细胞比例,对造血干/祖细胞增殖具促进作用;双黄升白颗粒具有保护模型小鼠骨髓造血微环境作用;双黄升白颗粒升高模型动物SI,具有一定的免疫增强作用。结论:双黄升白颗粒剂具有明显升高白细胞作用,其作用机制与促进造血细胞增殖及保护骨髓造血微环境有关。