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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-CSF5μg/(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。
Objective To investigate the effects and influencing factors of mobilization of peripheral blood stem cells (PBSC) by paclitaxel combined with recombinant human granulocyte colony-stimulating factor (rhG-CSF) in patients with breast cancer. Methods From February 2006 to June 2009, 26 patients with breast cancer who received paclitaxel mobilization were treated with paclitaxel (PTX, 175 mg / m2, continuous intravenous infusion for 24 hours), and the leucocyte count decreased to 1.0 × 109 / L When using rhG-CSF5μg / (kg.d) mobilization until the end of the acquisition. And further analysis of the patient’s age, the lowest number of leukocytes after chemotherapy, before the collection of various types of blood cells, postoperative staging and previous chemotherapy and other factors on the mononuclear cell (MNC), CD34 + cells. Results The white blood cell count decreased to 1.0 × 109 / L at 7d after paclitaxel chemotherapy and 4h after rhG-CSF injection. The total number of MNCs was 7.89 ± 1.45 × 108 / kg, and the total CD34 + Cells average (4.88 ± 1.54) × 106 / kg. Age was significantly correlated with the number of CD34 + cells collected. While other factors had no significant effect on the number of MNC and CD34 + cells (P> 0.05). No serious adverse reactions occurred in all patients. Conclusions PTX (175 mg / m2, continuous intravenous infusion for 24 hours) combined with rhG-CSF is an effective and safe mobilization for patients with metastatic breast cancer. Patient age significantly affected the number of CD34 + cells harvested.