大剂量多西他塞联合粒细胞集落刺激因子用于恶性实体瘤外周血造血干/祖细胞动员
High-dose Docetaxel with Granulocyte Colony-stimulating Factor for Mobilization of Autologous Peripheral Blood Stem/Progenitor Cells in Patients with Malignant Solid Tumors
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摘要: 目的观察大剂量多西他塞联合粒细胞集落刺激因子(G-CSF)在恶性实体瘤患者动员采集自体外周血造血干/祖细胞的有效性和安全性。方法30例恶性实体瘤患者入组,第一天采用多西他塞120mg/m2经静脉持续滴注3小时,在白细胞1.0×109/L左右时每天给予G-CSF5μg/kg,分早晚两次皮下注射,直至采集结束。结果在给予多西他塞后平均第(6.47±1.01)天白细胞降至1.0×109/L,皮下注射G-CSF平均(3.50±1.01)天即多西他塞动员后平均第(9.97±1.03)天开始外周血造血干/组细胞单采,每人每天采集一次,采集两天,共获CD34+细胞中位数3.49×106/kg(1.71×106~16.69×106/kg),其中CD34+细胞>2.0×106/kg的患者25例。不同采集时间获CD34+细胞数差异无统计学意义(P=0.651)。6例发生关节轻度疼痛,3例轻度腹泻,1例口腔粘膜炎。结论多西他塞120mg/m2联合G-CSF5μg/kg是恶性实体瘤患者动员采集自体干/祖细胞的有效安全方案。Abstract: Objective The efficacy of high-dose therapy(HDT) with peripheral blood progenitor cell(PBPC) transplantation for patients with solid tumors remains undefined.An important prerequisite for this mode of therapy is a reliable methord of obtaining sufficient PBPCs to ensure rapid and durable engraftment while maintaining patients in at least a stable disease state at the time of commencing the high-dose phase of therapy.Docetaxel has an effective anti-tumour activity in mang solid tumors.The objective of our study is to explore the efficacy and safety of high2dose of docetaxel with granulocyte colony2stimulating factor ( G2CSF) for mobilization of peripheral blood stem cells. Methods The 30 patient s with malignant solid tumors were involved in our study. Docetaxel (120 mg/ m2 ) was given with a continuous int ravenous infusion for 3 hours on day 1. When the number of white blood cell was reached to 1. 0 ×109 / L, G2CSF 5μg/ kg was given twice a day by injection subcutaneous until the end of leukopheresis. Results The leukopheresis was started on average day 9. 97 ±1. 03 following docetaxel therapy, the mean number of CD34 + cells was 3. 49 ×106 / kg ( range 1. 71 ×106 / kg~16. 69 ×106 / kg), by two times per patient of leukopheresis. There are 25 cases whose number of CD34 + cells is more than 2. 0 ×106 / kg. The average day is (6. 47 ±1. 01) when the number of white blood cells was reduced to 1. 0 ×109 / L af ter docetaxel was given. The average duration is (3. 50 ±1. 01) days for G2CSF injection subcutaneous. No significant difference in number of CD34 + cells was found in different leukopheresis time. 6 cases had mild arthralgia, 3 cases had slight diarrhea, 1 cases had oropharyngeal mucositis. Conclusion Docetaxel (120 mg/m2 ) with G2CSF(5μg/ kg) is an effective and safety mobilizing regimen for autologous peripheral blood stem progenitor cells in patient s with malignant solid tumors.