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目的:评价环磷酰胺(CTX)联合G-CSF(粒细胞集落刺激因子)对自体外周血造血干细胞(PBSC)的动员效果和毒性反应。方法:CTX3.5～4g/m2第1、2天静滴,WBC降至最低点时开始注射G-CSF4.5(3.5～5)μg/kg·天,至PBSC采集结束。当WBC恢复至(1.9～3.0)×109/L以上,以及MNC(单个核细胞)≥20%～30%和外周血CD34+≥1%时采集APBSC,当累计采集MNC≥2.0×108/kg和CD34+细胞≥2.0×106/kg时停止采集。结果:23例患者经CTX+G-CSF动员后第9(7～10)天WBC最低,为0.65(0.25～0.9)×109/L,G-CSF给药开始时间为动员后第10(8～11)天,持续6.5(5～11)天,第13(11～20)天开始采集PBSC,持续2天,采集得MNC2.5(1.3～8.9)×108/kg,CFU-GM6.8(2.8～11.6)×105/kg,CD34+细胞4.9(2.5～8.9)×106/kg,1例患者出现心包炎,无其他严重毒性反应;21例接受自体外周血干细胞移植支持下超大剂量化疗均获得满意造血重建。结论:CTX联合G-CSF是高效和安全的PBSC动员方案,值得临床广泛应用。
Objective: To evaluate the mobilization efficacy and toxicity of cyclophosphamide (CTX) combined with G-CSF (granulocyte colony-stimulating factor) on autologous peripheral blood stem cells (PBSC). METHODS: On the first and second days of CTX 3.5-4 g/m2 intravenous infusion, G-CSF 4.5 (3.5-5) μg/kg·day was injected when WBC reached the lowest point, and the PBSC collection was completed. APBSC was collected when WBC recovered to (1.9-3.0) × 109 / L or more, and MNC (mononuclear cells) ≥ 20% ~ 30% and peripheral blood CD34 + ≥ 1%, when the cumulative acquisition of MNC ≥ 2.0 × 108/kg and When CD34+ cells ≥ 2.0×106/kg, collection was stopped. Results: Twenty-three patients had the lowest WBC at the 9th (7-10th) day after CTX+G-CSF mobilization, 0.65 (0.25-0.9)×109/L, and G-CSF administration started at 10 (8) after mobilization. (11) days, lasting 6.5 (5 to 11) days. PBSC was collected on the 13th (11th to 20th) day for 2 days. MNC2.5 (1.3 to 8.9) × 108/kg was collected. CFU-GM6.8 (2.8～11.6)×105/kg, CD34+ cells 4.9 (2.5～8.9)×106/kg, 1 patient presented with pericarditis and no other severe toxicity; 21 patients received super-dose chemotherapy under the support of autologous peripheral blood stem cell transplantation. Get satisfied with hematopoietic reconstruction. Conclusion: CTX combined with G-CSF is an efficient and safe PBSC mobilization program, which is worthy of extensive clinical application.