化疗加G-CSF和GM-CSF联合动员自体外周血干细胞

目的　探讨化疗加粒细胞集落刺激因子 (G CSF)和粒 巨噬细胞集落刺激因子 (GM CSF)联合动员自体外周血干细胞 (APBSC)的效果。方法　卡铂 (CBP) 35 0mg m2 ,第 1天静滴 ;足叶乙甙(Vp16 ) 35 0mg m2 ,第 1～第 3天静滴 ;白细胞降至最低点又回升到 (2 .4～ 6 .4)× 10 9 L时 ,皮下注射G CSF 5 μg·kg- 1 ·d- 1 (早 6∶0 0 ) GM CSF 5 μg·kg- 1 ·d- 1 (晚 6∶0 0 ) 地塞米松 5mg d(采集日 10mg d)直到采集结束前 1天 ;白细胞上升到 (2 9.80± 5 .98)× 10 9 L ,开始用CS30 0 0plus血细胞分离机连续 2d采集APBSC。结果　 2 0例患者连续采集APBSC 2次 ,共采集到MNC(5 .93± 1.6 2 )× 10 8 kg ,CD34 细胞 (2 3.10± 11.5 3)× 10 6 kg ,CFU GM(3.44± 2 .85 )× 10 5 kg。无严重不良反应。 9例 10次自体外周血干细胞移植(APBSCT)造血功能均获满意重建。结论　以化疗联合G CSF和GM CSF能高效、安全地动员APBSC ,1次动员采集 2次可满足 1～ 2次的APBSCT。

Mobilization of autologous peripheral blood stem cells by chemotherapy and recombinant granulocyte colony stimulating factor(G-CSF) and granulocyte macrophage colony stimulating factor(GM-CSF)

OBJECTIVE: To observe the efficacy of chemotherapy and recombinant granulocyte colony-stimulating factor (G-CSF, Glycosylated) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in autologous peripheral blood stem cells (APBSC) mobilization. METHODS: The mobilization regimen: CBP 350 mg/m(2) intravenously injected at day 1, Vp16 350 mg/m(2) intravenously injected from day 1 to day 3. G-CSF and GM-CSF 5 microg x kg(-1) x d(-1) each, subcutaneously injected and DXM 5 mg/d intramuscularly injected, from the day of white blood cell (WBC) recovery to (2.4 - 6.4) x 10(9)/L from nadir to the day before the end of APBSC harvesting. APBSC harvesting started when WBC > 20.0 x 10(9)/L and ended when accumulated mononuclear cells (MNC) > 5 x 10(8)/kg. CFU-GM assay and CD(34)(+) cells counting of the APBSC were performed. RESULTS: Twenty cases underwent APBSC mobilization. APBSC harvest began at day 22.15 +/- 3.66 for two successive days. Accumulated MNC was (5.93 +/- 1.62) x 10(8)/kg, CD(34)(+) cells (23.10 +/- 11.53) x 10(6)/kg and CFU-GM (3.44 +/- 2.85) x 10(5)/kg. No severe toxicity was observed. Hematopoiesis was well reconstituted in 8 patients received single and in 1 patient received double APBSC transplantations. CONCLUSION: Chemotherapy combined with G-CSF + GM-CSF was a safe and highly effective method for APBSC mobilization.