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目的 :观察重组人粒细胞集落刺激因子 (rhG CSF)隔日皮下注射 ,在小儿急性白血病 (AL)强化疗后的临床作用。方法 :12例小儿 (AL)接受强化疗后白细胞≤ 1 0× 10 9/L(骨髓进入抑制期 )时 ,用rhG CSF每次 2～ 5μg/kg,隔日三角肌处皮下注射 ,查外周血 :白细胞≥ 2 5× 10 9/L时停止使用。并记录白细胞减低持续时间 ,患儿感染情况 ,同时对外周血出现幼稚细胞者 ,2周后骨髓涂片了解骨髓情况。选用既往相同年龄、相同类型AL患儿 ,用相同化疗方案 ,未使用rhG CSF ,同样例数作对照。结果 :治疗组白细胞≥ 2 .5× 10 9/L需天数 ( 6± 2 7天 ) ,比对照组 ( 13± 3天 )明显缩短 (t=6.0 6,P <0 .0 1)。且使用rhG CSF组出现较轻感染或不感染。多数能安全渡过骨髓抑制期 ,而对照组多感染重或多重感染 ,抗感染治疗疗效差。 6例患者使用rhG CSF后外周血出现幼稚细胞 ,但停药 2周后复查骨髓仍处于缓解期。结论 :隔日皮下注射rhG CSF每次 2～ 5 μg/kg ,可明显缩短小儿AL强化疗后骨髓抑制期 ,有效防止和控制继发感染
Objective: To observe the clinical effect of recombinant human granulocyte colony stimulating factor (rhG CSF) administered subcutaneously every other day after intensive chemotherapy in children with acute leukemia (AL). Methods: Twelve children with acute leukemia (≤10 × 10 9 / L) were treated with rhG CSF (2 ~ 5 μg / kg every time), subcutaneous injection of deltoid muscle every other day, : Leukocytes ≥ 2 5 × 10 9 / L, stop using. And record leukopenia duration, infection in children, while naive cells appear in peripheral blood, bone marrow smear after 2 weeks to understand the situation of bone marrow. Select the same age, the same type of AL children, with the same chemotherapy, no use of rhG CSF, the same number as a control. Results: The number of days required for treatment of leukocytes ≥ 2.5 × 10 9 / L (6 ± 27 days) in treatment group was significantly shorter than that in control group (13 ± 3 days) (t = 6.06, P <0.01). And the use of rhG CSF group showed mild or no infection. The majority of patients were able to survive myelosuppression safely, while the control group had multiple infections with multiple or multiple infections with poor anti-infective therapy. 6 cases of peripheral blood cells after rhG CSF appear naive cells, but after 2 weeks of withdrawal check the bone marrow is still in remission. CONCLUSION: Every other day, 2 ~ 5 μg / kg rhG CSF is injected subcutaneously, which can obviously shorten the myelosuppression period after ALI in children and effectively prevent and control the secondary infection