造血生长因子在化疗患者中的应用

在肿瘤患者的化疗中,血液学毒副作用是非常突出和急需解决的主要问题,造血生长因子在减少血液学毒副作用、降低化疗风险和提高肿瘤患者生活质量方面都起着非常重要的作用。其中粒细胞集落刺激因子在化疗患者中应用最为广泛,NCCN指南建议对化疗后出现粒缺发热的高危患者预防性使用粒细胞集落刺激因子。红细胞生成素由于近期有几项临床试验表明可能增加死亡率,甚至减少总生存,因此其应用还有待进一步的研究。促血小板生成素目前仍处于Ⅲ期和Ⅳ期临床试验中,前景令人鼓舞。

Hematopoietic growth factors in chemotherapy

For tumor patients undergoing chemotherapy,hematologic toxicity is very difficult to prevent and control.Hematopoietic growth factors play an important role in reducing the hematologic toxicity, lowering the chemotherapy risk,and improving the quality of life.Granulocyte colony-stimulating factors （CSF） are widely used with chemotherapy.NCCN guidelines suggest to prophylacticly use G-CSF for high-risk patients with febrile neutropenia.Erythropoiesis-stimulating agents have been reported to increase mortality and even decrease the overall survival in several large clinical trials,so its clinical application is still in controversy.Thrombopoietic growth factors are still in stage Ⅲ or Ⅳ clinical trials with promising perspective.