rhG-CSF与rhGM-CSF动员人外周血单核细胞后DC疫苗数量及功能变化的比较

目的 探讨利用人外周血单核细胞制备树突状细胞（dendritic cell, DC）疫苗过程中，使用重组人粒细胞集落刺激因子（recombinant human granulocyte colony-stimulating factor，rhG-CSF）和重组人粒细胞巨噬细胞集落刺激因子（recombinant human granulocyte/macrophage colony-stimulating factor, rhGM-CSF）进行动员的临床应用可行性，并比较两者作为动员试剂的优劣。方法 对2011年8月至2013年12月中国人民解放军第81医院肿瘤生物治疗科进行DC疫苗治疗的恶性肿瘤患者134例进行随机分组，其中rhG-CSF动员者69例，rhGM-CSF动员者65例。rhG-CSF动员组在血细胞分离机采集前1天行rhG-CSF皮下注射3 μg/(kg·d)，rhGM-CSF动员组在血细胞分离机采集前1天行rhGMCSF皮下注射3 μg/(kg·d)。比较两组动员前后血常规变化的差异；分析两组采集终产品中单个核细胞（mononuclear cell, MC）数量及表型，检测体外培养所得DC的数量、表型及细胞因子的表达。结果 动员后rhGM-CSF动员组单核细胞增高值高于rhG-CSF动员组（P≤0.001），但中性粒细胞计数增高值低于rhG-CSF动员组（P≤0.001），其余血常规项目两者差异无统计学意义。rhGMCSF动员组采集终产品中单个核细胞数量高于rhG-CSF动员组（P=0.046），而CD14+单核细胞的比例两组差异无统计学意义。rhGM-CSF动员组最终诱导所得DC数量高于rhGCSF动员组（P=0.011），且DC细胞表面分子HLA-DR的表达高于rhG-CSF动员组（P=0.001），其余CD80、CD86，CD83、CD11C、CD54表达两组差异无统计学意义。两组DC细胞Th1型和Th2型细胞因子的表达差异都无统计学意义。结论 在用人外周血单核细胞制备DC疫苗的过程中，使用rhGM-CSF动员比rhG-CSF更有优势。

Comparison of rhG-CSF and rhGM-CSF Mobilization on Quantity and Function Change of Dendritic Cell-based Tumor Vaccine via Human Peripheral Blood Monocytes

Objective To investigate the clinical application of recombinant human granulocyte colonystimulating factor(rhG-CSF) and recombinant human granulocyte/macrophage colony-stimulating factor(rhGM-CSF) mobilization on human peripheral blood monocytes for dendritic cell-based tumor vaccine. Methods We randomly divided 134 tumor patients using dendritic cell(DC) vaccine in the Ceuter of Tumor Biological Therapy, 81 Hospital of PLA from August 2011 to December 2013 into two groups as follows: rhG-CSF group (n=69) and rhGM-CSF group (n=65). rhG-CSF group were injected rhG-CSF subcutaneously 3μg/(kg·d) and rhGM-CSF group were injected rhGM-CSF subcutaneously 3μg/(kg·d) before apheresis using a blood cell separator. Blood routine examination was taken before and after mobilization. The number and phenotype of peripheral blood mononuclear cells(PBMCs) in final apheresis products of two groups were analyzed as well as DC numbers. The phenotypes of DC and cytokines expression were analyzed. Results After mobilization, peripheral blood monocytes counting of rhGM-CSF group were higher than that of rhG-CSF group, while neutrophil counting were lower(P≤0.001). There was no significant difference in other two blood routine examination items. The PBMCs quantity of rhGM-CSF group was greater than that of rhG-CSF group(P=0.046) as well as DC quantity(P=0.011). The CD14+ monocytes to mononuclear cell ratio of the two groups showed no significant difference. The surface molecule HLA-DR expression of DC cells in rhGM-CSF group were higher than that in rhG-CSF group(P=0.001) while no significant differences in the expression of CD11C, CD80, CD86, CD83 and CD54 were found between two groups. Th1 and Th2 cytokines expression of DC showed no difference between two groups. Conclusion rhGM-CSF mobilization is better than rhG-CSF mobilization in the progress of preparing dendritic cell-based tumor vaccine via human peripheral blood monocytes.