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紫杉醇联合重组人粒细胞集落刺激因子动员 乳腺癌患者外周血干细胞的效果及影响因素

Efficacy and Factors Involved in Mobilization of Peripheral Blood Stem Cell in Metastatic Breast Cancer Patients after Paclitaxel Plus G-CSF Treatment

  • 摘要: 目的研究紫杉醇联合重组人粒细胞集落刺激因子(rhG-CSF)动员乳腺癌患者外周血干细胞(peripheral blood stem cell,PBSC)的效果及影响因素分析。方法2006年2月至2009年6月我科收治行紫杉醇动员的26例乳腺癌患者,紫杉醇(PTX,175 mg/m2 持续静脉滴注24 h)化疗后,白细胞降至1.0×109/L左右时使用rhG-CSF 5 μg /(kg·d) 动员至采集结束。并进一步分析患者年龄,化疗后白细胞最低数,采集前各类血细胞数,术后分期以及既往化疗等因素对采集单个核细胞(mononuclear cell,MNC)、CD34+细胞数的影响。结果白细胞计数于紫杉醇化疗后中位7d降至1.0×109/L 左右,皮下注射rhG-CSF中位4d进行外周造血干细胞采集,采集总MNC平均(7.89±1.45)×108/kg,采集总CD34+细胞平均(4.88±1.54)×106/kg。年龄与采集CD34+细胞数显著相关。而其他因素对MNC及CD34+细胞数均无显著影响(P>0.05)。所有患者均未出现严重不良反应。结论PTX(175 mg/m2 持续静脉滴注24h)联合rhG-CSF为转移性乳腺癌患者动员的有效安全方案。患者年龄显著影响CD34+细胞的采集数量。

     

    Abstract: Abstract:ObjectiveTo study the efficacy and factors that affect peripheral blood stem cell (PBSC)mobilization of patients with breast cancer treated by paclitaxel plus recombinant human G-CSF(rhG-CSF). Methods Twenty-six patients with breast cancer were included in our study.PTX at the dose of 175 mg/m2 was continuously given for 24 hours.When the number of white blood cell reached 1.0×109/L,rhG-CSF was given until the end of leukopheresis.The mononuclear cells (MNC)and CD34+ cells collected by a continuous flow cell separator from peripheral blood were analyzed with FACS.Various factors affecting the yield of CD34+,including age, the lowest leucocyte counts after chemotherapy, the blood cell counts before leukopheresis, pathological stage, prior chemotherapy were analyzed. Results The leukopheresis was started on the median 10th day following mobilization chemotherapy.The mean values of MNC and CD34+cells were (7.89±1.45)×108/kg and (4.88±1.54)×106/kg,respectively.The age was related with CD34+ cells counts.The other factors didn't significantly affect the CD34+ cells counts (P>0.05).No serious side effect was observed. Conclusion PTX combined with rhG-CSF was an effective and safe mobilization regimen for autologous peripheral blood stem progenitor cells of patients with breast cancer.The age affected the collected number of CD34+ cells.

     

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