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背景与目的:通过动员采集获得高质量的自体外周血造血干细胞(autologousperipheralbloodstemcell,APBSC)是造血干细胞移植成功的关键,环磷酰胺(cyclophosphamide,CTX)联合重组人粒细胞集落刺激因子(recombinedhumangranulocytecolony-stimulatingfactor,rhG-CSF)是APBSC经典的动员方案,足叶乙甙(etoposide,VP-16)联合rhG-CSF是近年来应用的另一个动员方案。本研究的目的是比较上述两种动员方案对恶性淋巴瘤和生殖细胞肿瘤患者APBSC的动员效果。方法:共有52例恶性实体瘤患者,其中CTX方案组26例,剂量为CTX3.5g/m2加rhG-CSF5μg·kg-1·d-1;VP-16方案组26例,VP-16的剂量随机采用1000mg/m2或1500mg/m2加rhG-CSF5μg·kg-1·d-1。两组均在白细胞(whitebloodcell,WBC)降至最低点时开始皮下注射rhG-CSF,直至采集结束前一天。当CTX组WBC恢复到2.5×109/L、VP-16组WBC恢复到5.0×109/L以上时开始连日采集APBSC,当累计采集的单个核细胞(mononuclearcell,MNC)≥5×108/kg或CD34+细胞≥2×106/kg时停止采集。患者经预处理后回输采集到的APBSC。比较两组动员采集过程中的血液学指标变化、采集细胞数量、造血重建时间、不良反应等。结果:CTX组患者化疗后外周血中WBC和血小板(platelet,PLT)降至最低值的时间明显早于VP-
BACKGROUND & OBJECTIVE: To obtain high-quality autologous peripheral blood stem cells (APBSCs) by mobilization and acquisition is the key to the success of hematopoietic stem cell transplantation. Cyclophosphamide (CTX) combined with recombinant human granulocyte-stimulating factor rhG-CSF) is a classic mobilization regimen of APBSC. etoposide (VP-16) combined with rhG-CSF is another mobilization scheme applied in recent years. The purpose of this study was to compare the mobilization effects of the above two mobilization regimens for patients with malignant lymphoma and germ cell tumors with APBSC. Methods: A total of 52 patients with malignant solid tumors, CTX program group of 26 patients, the dose of CTX3.5g / m2 plus rhG-CSF5μg · kg-1 · d-1; VP-16 program group of 26 patients, VP-16 dose Randomly using 1000mg / m2 or 1500mg / m2 plus rhG-CSF5μg · kg-1 · d-1. Both groups began to inject rhG-CSF subcutaneously at the lowest white blood cell (WBC) level until the day before the end of the collection. When the WBC in CTX group recovered to 2.5 × 109 / L and the WBC in VP-16 group recovered to above 5.0 × 109 / L, APBSC was started for the same day. When the accumulated mononuclear cell (MNC) ≥5 × 108 / kg or CD34 + cells ≥ 2 × 106 / kg stop collecting. Patients were pre-treated and collected APBSCs were transfused. The changes of hematological indexes during the mobilization and collection of the two groups were compared, the number of cells collected, the time of hematopoietic reconstitution, adverse reactions and so on. Results: The time to minimize WBC and platelet (PLT) in peripheral blood after chemotherapy in CTX group was significantly earlier than that in VP-