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目的 观察环磷酰胺 (CTX)为主的联合化疗加重组人粒细胞集落刺激因子 (rhG CSF)对自体外周血干细胞 (APBSC)的动员效果。方法 CTX(2 5± 1 0 )g/m2 静脉点滴 ,第 1天 ;足叶乙甙(Vp 16 ) 6 0 0～ 80 0mg和 (或 )阿糖胞苷 (Ara C) 1 0～ 2 0g/m2 静脉点滴 ,第 2天。白细胞 (WBC)降至最低点时开始皮下注射rhG CSF 30 0 μg/d ,直至采集结束前一天。当WBC上升至 >3 0× 10 9/L时开始连日采集APBSC ,当单个核细胞 (MNC)累计达到 4× 10 8/kg以上时停止采集 ,并检测APBSC中的CFU GM和CD34 + 细胞。结果 2 0例患者APBSC动员后 (8 5± 1 5 )dWBC最低 ,为 (1 2± 0 8)× 10 9/L ,(9 0±2 0 )d时开始给予rhG CSF ,持续 (6 0± 1 0 )d ,(12 0± 2 0 )d时开始采集APBSC ,持续 (4 0± 1 0 )d。采集的MNC为 (6 14± 2 34 )× 10 8/kg ,CD34 + 细胞为 (2 3 2 5± 30 5 6 )× 10 6/kg ,CD34 + 细胞升至峰值时间在化疗后 (14 6± 1 8)d ,在用rhG CSF后 (4 9± 1 6 )d ,CFU GM为 (2 1 6 8± 15 39)× 10 4 /kg;全组无严重毒副反应 ;全部移植患者造血功能均获满意重建。结论 CTX为主的联合化疗加rhG CSF是一种安全、可行的APBSC动员方法。
Objective To observe the mobilization of autologous peripheral blood stem cells (APBSC) by cyclophosphamide (CTX) -mediated combination chemotherapy and rhG-CSF (recombinant human granulocyte-colony stimulating factor). Methods CTX (25 ± 1 0) g / m2 was given intravenously on the first day. Puerarin (Vp16) 600 ~ 80 0mg and Ara C 10 ~ 20g / m2 intravenous drip, the first two days. At the lowest point of white blood cell (WBC), rhG CSF 30 0 μg / d was injected subcutaneously until the day before the end of the collection. When WBC increased to> 3 0 × 10 9 / L, APBSCs were collected continuously for several days. When the number of MNCs reached 4 × 10 8 / kg or more, collection was stopped and CFU GM and CD34 + cells in APBSC were detected. Results The lowest dWBC was (12 ± 0 8) × 10 9 / L after mobilization of APBSC in 20 patients, and rhG CSF was started at (90 ± 20) d, ± 1 0) d, (12 0 ± 20) d, APBSC was collected and continued for (40 ± 1 0) d. The number of CD34 + cells and the number of CD34 + cells increased to the peak at 6 14 ± 2 34 × 10 8 / kg and 2 3 2 5 ± 30 5 6 × 10 6 / kg after chemotherapy ± 18) d. The CFU GM was (2168 ± 1539) × 10 4 / kg after treated with rhG CSF for 49 ± 16 days, and no severe side effects were observed in the whole group. Features are satisfied with the reconstruction. Conclusion CTX-based combination chemotherapy plus rhG CSF is a safe and feasible method for mobilization of APBSC.