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目的探讨以中剂量环磷酰胺为主联合化疗加单一剂量重组人粒细胞集落刺激因子(GCSF)对恶性血液病患者自体外周血造血干细胞的动员效果。方法31例患者接受中剂量环磷酰胺2.2g/m2(1.8~3.0g/m2)联合鬼臼乙叉甙(Vp16)600~800mg(CE方案)或阿糖胞苷(AraC)1.0~2.0g/m2(CA方案)化疗。预处理后,予以回输所采自体外周血造血干细胞,观察造血重建情况。结果动员所需时间(化疗开始至采集的平均时间)为(13.5±2.0)d,采集次数为(2.9±1.0)次,WBC最低值为(0.95±1.0)×109/L,GCSF开始给药时间为第(8.6±2.0)天,持续应用平均(7.4±2.0)d,采集到的单个核细胞数为(5.53±2.54)×108/L,CD34+细胞数为(9.46±7.24)×106/L,粒单核细胞集落数为(46.02±70.58)×104/L。全部移植患者造血功能均获满意重建。结论中剂量环磷酰胺为主联合化疗(CE/CA)加单一剂量GCSF对恶性血液病患者的造血干细胞动员是安全和有效的。
Objective To investigate the mobilization effect of autologous peripheral blood hematopoietic stem cells in patients with hematologic malignancies by using medium dose cyclophosphamide combined with chemotherapy and single dose recombinant human granulocyte colony stimulating factor (GCSF). Methods Thirty - one patients received 600-800 mg (CE) of cyclophosphamide 2.2g / m2 (1.8-3.0g / m2) combined with etoposide (Vp16) or 1.0-2.0g of cytarabine (AraC) / m2 (CA regimen) chemotherapy. After pretreatment, they were transfused from peripheral blood hematopoietic stem cells and the hematopoietic reconstitution was observed. Results The time required for mobilization (mean time from the start of chemotherapy to collection) was (13.5 ± 2.0) d, (2.9 ± 1.0) times and the lowest value of WBC was (0.95 ± 1.0) × 109 / L The average number of mononuclear cells collected was (5.53 ± 2.54) × 108 / L and the number of CD34 + cells was (9.46 ± 7.24) × 106 / L, the number of mononuclear cells was (46.02 ± 70.58) × 104 / L. All patients with hematopoietic function were satisfactory reconstruction. Conclusions The combination of medium dose cyclophosphamide with combined chemotherapy (CE / CA) and single dose GCSF is safe and effective in mobilizing hematopoietic stem cells from patients with hematologic malignancies.