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目的检测急性髓系白血病(AML)患儿化疗前、化疗结束后骨髓抑制期及骨髓恢复期骨髓细胞表面粒细胞集落刺激因子受体(G-CSFR)的表达率变化,观察并比较患儿G-CSFR表达率与化疗后感染发生、恢复情况的关系,探讨化疗结束后应用重组人粒细胞集落刺激因子(rhG-CSF)的合适时机及剂量。方法 AML患儿78例随机分为A组、B组。应用流式细胞术及CD114单克隆抗体检测A组39例AML患儿化疗前、化疗结束后骨髓抑制期及骨髓恢复期骨髓细胞表面G-CSFR的表达率,分析其变化规律,并于化疗结束后立即分别给予A组50μg.d-1.m-2与B组100μg.d-1.m-2的rhG-CSF,观察比较不同组别骨髓抑制期和感染持续时间。结果 A组化疗前G-CSFR的表达率为(33.10±20.94)%,化疗结束后骨髓抑制期G-CSFR的表达率为(23.28±13.02)%,骨髓恢复期G-CSFR的表达率为(30.12±15.76)%,化疗前、化疗结束后骨髓抑制期及恢复期G-CSFR表达率比较差异无统计学意义。A组与B组比较,骨髓抑制期持续时间和感染持续时间比较差异均无统计学意义。结论化疗结束后,早期应用较低剂量(50μg.d-1.m-2)rhG-CSF即可利于中性粒细胞的恢复,缩短无细胞期,降低感染发生率。
Objective To detect the changes of G-CSFR expression on myeloid cells before and after chemotherapy in patients with acute myeloid leukemia (AML). To observe and compare the changes of G-CSFR expression in children with acute myeloid leukemia -CSFR expression and the incidence of post-chemotherapy infection, the recovery of the relationship between the end of chemotherapy after the application of recombinant human granulocyte colony-stimulating factor (rhG-CSF) the appropriate timing and dosage. Methods AML children 78 cases were randomly divided into A group, B group. Flow cytometry and CD114 monoclonal antibody was used to detect the expression of G-CSFR on bone marrow cells before and after chemotherapy in 39 cases of AML children with AML. The changes of G-CSFR expression on bone marrow cells were analyzed. At the end of chemotherapy Immediately after administration of 50μg.d-1.m-2 in group A and 100μg.d-1.m-2 in group B, rhG-CSF was respectively administrated. The bone marrow suppression and duration of infection in different groups were observed and compared. Results The expression of G-CSFR in group A was (33.10 ± 20.94)% before chemotherapy, the expression rate of G-CSFR in bone marrow was (23.28 ± 13.02)% after chemotherapy, and the expression rate of G- 30.12 ± 15.76)%. There was no significant difference in the expression of G-CSFR between pre-chemotherapy and post-chemotherapy bone marrow suppression and recovery phase. There was no significant difference in the duration of bone marrow suppression and duration of infection between group A and group B. Conclusion After the chemotherapy, early application of lower doses (50μg.d-1.m-2) of rhG-CSF can be beneficial to the recovery of neutrophils, shorten the cell-free period and reduce the incidence of infection.