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目的:研究紫杉醇(TXL)联合粒细胞集落刺激因子(G-CSF)在恶性实体瘤患者动员外周血干细胞(PBSC)的效率和安全性。方法:10例恶性实体瘤患者入组,第1d给予化疗动员TXL175mg7m2～190mg7m2,在白细胞1.0×1097L左右时联合rhG-CSF5mg7Kg动员,分早晚2次皮下注射至采集结束,血细胞分离机分离外周血单核细胞(MNC),每日采集1次,共2次,流式细胞仪检测CD34+细胞占白细胞的百分率。结果:在给予化疗TXL中位8d后白细胞降至1.0×1097L左右,皮下注射G-CSF中位4d,即化疗动员TXL中位12d后进行外周血造血干细胞采集,共采集20次。TXL动员获MNC6.12×1087Kg,CD34+细胞中位数7.05×1067Kg(1.89～11.84×1067Kg)。单次采集获得CD34+细胞大于2.0×1067Kg占总采集次70%;占总例数90%。所有患者均能耐受动员、采集全过程,相关不良反应较轻,经对症处理后均缓解。结论:TXL联合G-CSF是恶性实体瘤患者动员采集自体干细胞的有效安全方案。
OBJECTIVE: To study the efficiency and safety of paclitaxel (TXL) combined with granulocyte-colony stimulating factor (G-CSF) mobilizing peripheral blood stem cells (PBSC) in patients with malignant solid tumors. Methods: Ten patients with malignant solid tumors were enrolled in the study. On the first day, TXL175mg7m2 ~ 190mg7m2 was mobilized by chemotherapy. When leukocytes were about 1.0 × 1097L, rhG-CSF5mg, 7Kg was mobilized, subcutaneously injected twice or sooner or later to the end of the collection. Blood cells were separated from peripheral blood mononuclear cells Nuclear cells (MNC) were collected once a day for 2 times. The percentage of CD34 + cells to leucocytes was detected by flow cytometry. Results: Leukocyte decreased to 1.0 × 1097L after the median of TXL was given for 4 days, and the median of G-CSF was injected subcutaneously for 4 days. After 12 days of TXL chemotherapy, peripheral blood hematopoietic stem cells were collected for 20 times. TXL mobilization was 6.12 × 1087Kg MNC, median CD34 + cells 7.05 × 1067Kg (1.89 ~ 11.84 × 1067Kg). Single acquisition of CD34 + cells greater than 2.0 × 1067Kg accounted for 70% of the total acquisition; the total number of cases 90%. All patients were able to tolerate mobilization, collecting the whole process, the relevant adverse reactions were mild, symptomatic treatment were relieved. Conclusion: TXL combined with G-CSF is an effective safety regimen for mobilizing autologous stem cells in patients with solid tumors.