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在体外已证明多种造血生长因子有刺激骨髓祖细胞生长的功能。粒-巨噬细胞集落刺激因子(GM-CSF)是一种糖蛋白激素,在体外能诱导造血祖细胞形成粒、巨噬、嗜酸细胞集落。在某些情况下对红、巨核细胞集落的形成也有作用。另外,GM-CSF 对成熟中性粒细胞的功能亦有显著作用。病人和方法本研究用重组人 GM-CSF(rhGM-CSF)治疗13例难治性再障和2例粒细胞缺乏症。患者年龄中位数45(16～75)岁。再障患者10例病因不明,2例由药物、1例由肝炎引起;粒细胞缺乏症患者1例为 T-gamma 综合征,1例为原发性。13例再障在接受 rhGM-CSF 治疗前2个月均用过抗胸腺细胞球蛋白治疗,10例无效,3例有短暂反应后复发。13例再障中,重型9例,中度4例。
Many in vitro hematopoietic growth factors have been shown to stimulate the growth of myeloid progenitor cells. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a glycoprotein hormone that induces the formation of granulocytes, macrophages and eosinophils in hematopoietic progenitor cells in vitro. In some cases, the formation of red and megakaryocyte colonies also has an effect. In addition, GM-CSF also has a significant effect on the function of mature neutrophils. Patients and Methods In this study, 13 patients with refractory aplastic anemia and 2 patients with agranulocytosis were treated with recombinant human GM-CSF (rhGM-CSF). The median age of patients was 45 (16-75 years). Aplastic anemia in 10 cases of unknown etiology, 2 cases by drugs, 1 case caused by hepatitis; agranulocytosis in 1 case of T-gamma syndrome, 1 case of primary. Thirteen patients with aplastic anemia were treated with antithymocyte globulin 2 months prior to rhGM-CSF treatment, 10 were ineffective, and 3 were relapsed after a brief response. 13 cases of aplastic anemia, 9 cases of moderate, moderate in 4 cases.