摘要
目的 评价环磷酰胺、长春新碱、依托泊苷、泼尼松 (COEP) /吡柔比星、长春新碱、依托泊苷、泼尼松(DOEP)动员方案对儿童急性淋巴细胞白血病和淋巴瘤自体外周血造血干细胞移植动员采集的临床效果。方法 以COEP方案和DOEP方案为动员化疗方案 ,观察采集干细胞效果。结果 13例 (6例非霍奇金淋巴瘤和 7例急性淋巴细胞白血病 )儿童采用COEP/DOEP方案动员 (8例用COEP方案 ,5例用DOEP方案 ) ,化疗后第 4～10d(平均 6d)白细胞数 <2× 10 9/L ,用粒细胞集落刺激因子后第 4～ 19d(平均 8d)开始采集外周血造血干细胞 ,采集单个核细胞数 (4 19～ 9 96 )× 10 8/kg(平均 6 78× 10 8/kg) ,CD34+细胞数 (2 90～ 12 78)× 10 6/kg(平均 8 90× 10 6/kg) ,粒单造血祖细胞数 (3 4 9～ 4 1 72 )× 10 4/kg(平均 15 5 7× 10 4/kg)。动员的并发症较轻 ,患儿均能耐受。自体外周血干细胞移植后均获快速造血功能重建 ,白细胞开始回升 (中性粒细胞绝对值 >0 5× 10 9/L)的时间为移植后 10～ 2 2d(平均 14d) ,血红蛋白恢复 (>80 g/L)的时间为移植后 10～ 2 8d(平均 17d) ,血小板恢复 (>2 0× 10 9/L)的时间为移植后 10～ 2 0d(平均 19d)。
Objective To evaluate the clinical effect of mobilization and collection by COEP/DOEP mobilizing chemotherapy program in children with acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma (NHL).Methods Protocol of COEP (cyclophosphamide,vincristine,etoposide and predonisone) or DOEP (perarubicin,vincristine,etoposide and predonisone) was used as mobilization chemotherapy in 13 cases (including 6 NHL and 7 ALL).Granulocyte colony stimulating factor (G-CSF) was given on the day when white blood cell (WBC) decreased to 2×10 9/L.Leukapheresis started when WBC reached to 3×10 9/L.Results Thirteen cases employed this program (8 cases using COEP and 5 cases using DOEP).WBC decreased to 2×10 9/L on day 6(4～10) after the chemotherapy.Collection began when WBC reached to 3.0×10 9/L by using G-CSF for 8(4～19)days.The volume of MNC,CD34+ cells and colony forming unit-granulocyte macrophage(CFU-GM) were 6.78(4.19～9.96)×10 8/kg,8.90(2.90～12.78)×10 6/kg and 15.57(3.49～41.72)×10 4/kg respectively.No severe complication was observed during the mobilization.Prompt and sustained hemocytoblastic reconstitution was observed in all the children.Neutrophilic granulocyte >0.5×10 9/L,hemoglobin >80g/ L and platelet >20×10 9/L were found on day + 14(10～22),+ 17(10～28)and +19(10～20) respectively.Conclusion COEP/DOEP is a highly efficient mobilization protocol in children with ALL or NHL.
出处
《中国实用儿科杂志》
CSCD
北大核心
2003年第11期676-678,共3页
Chinese Journal of Practical Pediatrics
