大剂量粒系集落刺激因子使老年急性髓系白血病患者受益

李巍; 孙明媛; 刘云涛; 宫本法; 张广吉; 魏述宁; 邱少伟; 秘营昌; 王建祥

doi:10.3971/j.issn.1000-8578.2018.17.1096

大剂量粒系集落刺激因子使老年急性髓系白血病患者受益

High-doses Granulocyte Colony-stimulating Factor (G-CSF) Benefit Elderly Patients with Acute Myeloid Leukemia

摘要

摘要:
目的探讨老年急性髓系白血病（AML）化疗期间预防性大剂量（> 5 μg/kg）和标准剂量（5 μg/kg）使用G-CSF对感染、输血情况的影响。
方法回顾性对比分析82例老年AML 273个化疗周期中两组G-CSF进行支持治疗中抗生素和抗真菌药物使用情况、发热天数、发热程度、粒缺时间、输血情况等。
结果 273个化疗周期中合并感染223次（81.7%），因感染中断治疗11例（13.4%）；标准剂量组中2例（2.3%）患者在诱导治疗期间死亡。亚组分析发现，大剂量组可明显缩短巩固治疗期间粒缺时间、发热天数及减少抗真菌药物的使用。
结论大剂量G-CSF可提高老年AML患者化疗期间的安全性、耐受性。

Abstract:
Objective To analyze the effects of high-dose (> 5 μg/kg) and standard-dose (5 μg/kg) granulocyte colony-stimulating factor (G-CSF) on infection and blood transfusion in elderly patients with acute myeloid leukemia (AML) during chemotherapy.
Methods During the 273 cycles of chemotherapy, 82 elderly patients with AML were treated with two doses of G-CSF. The use of antibiotics and antifungal agents, fever days, the degree of fever, neutropenia time and the blood transfusion were analyzed retrospectively.
Results In 273 cycles of chemotherapy, there were 223(81.7%) times of concurrent infection, 11(13.4%) patients were discontinued due to the infection; In standard treatment group 2(2.3%) patients died during induction treatment. Subgroup analysis showed the high-dose group significantly shortened the neutropenia and fever time and decreased the use of antifungal agents.
Conclusion High-dose G-CSF could improve the safety and tolerability of chemotherapy in elderly patients with AML.

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