Granulocyte Colony-Stimulating Factor

粒细胞集落刺激因子
  • 文章类型: Journal Article
    背景:本研究旨在探讨聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)对宫颈癌同步放化疗患者中性粒细胞减少症的初步预防效果和安全性。
    方法:在此前瞻性中,单中心,单臂研究,我们纳入了2018年国际妇产科联合会(FIGO)IIIC1r-IVA和IVB期(仅远处转移伴腹股沟淋巴结转移)宫颈癌患者(18~70岁).符合条件的患者应具有正常的骨髓功能(绝对中性粒细胞计数(ANC)≥2.0×109/L)和足够的肝和肾功能。主要排除标准包括:既往化疗和/或放疗;骨髓发育不良或其他造血异常病史。所有患者均接受根治性放射治疗(骨盆放射治疗或扩展视野照射)加近距离放射治疗。化疗方案包括4个周期的3周紫杉醇和顺铂。在每个治疗周期后48-72小时施用PEG-rhG-CSF。救助粒细胞集落刺激因子(G-CSF)仅在某些情况下才允许。主要终点是3-4级中性粒细胞减少症的发生率。次要终点包括发热性中性粒细胞减少症(FN)的频率,2-4周期化疗完成率,完成放疗的时间,和安全。
    结果:总体而言,从2019年7月至2020年10月,该研究纳入了52名患者。3-4级中性粒细胞减少的发生率为28.8%,3-4级中性粒细胞减少症的平均持续时间为3.85天(1-7天)。FN的发生率为3.8%。化疗完成率为94.2%,82.7%,周期2-4分别为75.0%。第1-4周期3-4级中性粒细胞减少症的发生率为9.6%(5/52),8.2%(4/49),14.0%(6/43),2.6%(1/39),分别。所有患者在8周内完成放疗(中位数,48天;范围:41-56天),除了1例撤回同意且未接受放疗的患者.在任何患者中均未观察到严重的非血液学毒性。
    结论:PEG-rhG-CSF是宫颈癌同步放化疗患者中性粒细胞减少的有效且安全的预防性治疗方法。
    背景:中国临床试验注册中心,ChiCTR1900024494。注册日期:2019年7月13日。
    BACKGROUND: This study aimed to investigate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) for primary prophylaxis of neutropenia in patients with cervical cancer receiving concurrent chemoradiotherapy.
    METHODS: In this prospective, single-center, single-arm study, we enrolled patients (18-70 years) with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1r-IVA and IVB (distant metastasis only with inguinal lymph node metastasis) cervical cancer. Eligible patients should have normal function of the bone marrow (absolute neutrophil count (ANC) ≥ 2.0 × 109/L) and adequate hepatic and renal functions. Key exclusion criteria included: previous chemotherapy and/or radiotherapy; a history of bone marrow dysplasia or other hematopoietic abnormalities. All patients underwent radical radiotherapy (pelvic radiotherapy or extended-field irradiation) plus brachytherapy. The chemotherapy regimen included four cycles of 3-weekly paclitaxel and cisplatin. PEG-rhG-CSF was administered 48-72 h after each treatment cycle. Salvage granulocyte colony-stimulating factor (G-CSF) was only permitted in certain circumstances. The primary endpoint was the incidence of grade 3-4 neutropenia. The secondary endpoints included frequency of febrile neutropenia (FN), chemotherapy completion rate in cycles 2-4, time to complete radiotherapy, and safety.
    RESULTS: Overall, 52 patients were enrolled in this study from July 2019 to October 2020. The incidence of grade 3-4 neutropenia was 28.8%, with an average duration of grade 3-4 neutropenia persistence of 3.85 days (1-7 days). The incidence rate of FN was 3.8%. The chemotherapy completion rate was 94.2%, 82.7%, and 75.0% for cycles 2-4, respectively. The incidences of grade 3-4 neutropenia for cycles 1-4 were 9.6% (5/52), 8.2% (4/49), 14.0% (6/43), and 2.6% (1/39), respectively. All patients completed radiotherapy within 8 weeks (median, 48 days; range: 41-56 days), except one patient who withdrew consent and did not receive radiotherapy. Severe non-hematologic toxicity was not observed in any patient.
    CONCLUSIONS: PEG-rhG-CSF is an effective and safe prophylactic treatment for neutropenia in patients with cervical cancer undergoing concurrent chemoradiotherapy.
    BACKGROUND: Chinese Clinical Trial Registry, ChiCTR1900024494. Date of Registration:13/July/2019.
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  • 文章类型: Journal Article
    在符合条件的多发性骨髓瘤(MM)患者的治疗中,建议使用大剂量化疗,然后进行自体造血干细胞支持。这项研究的目的是比较匈牙利患者人群中稳态与基于化疗的干细胞动员的疗效和安全性。
    受试者是210名MM患者,他们在2018年至2022年之间接受了干细胞动员程序。应用粒细胞集落刺激因子(G-CSF)104例,而106例患者接受化疗,随后给予G-CSF。我们评估了成功动员的比例,收集的干细胞的数量,两组的感染发生率和成本效益。
    在稳态组中,对plerixafor的需求显著增加(45%与13%,P<0.001),不成功的干细胞动员更频繁(11%vs.3%,P=0.024),收集的干细胞的平均数量较低(6.9vs.9.8×106,P<0.001)高于化疗组。然而,感染频率较低(4%vs.27%,P<0.001),住院天数显着降低(6vs.14天,P<0.001)。与接受其他方案治疗的患者相比,接受来那度胺或达拉图单抗的患者更频繁地使用Plerixafor(41%vs.23%,P=0.007和78%vs.23%,分别为P<0.001)。
    稳态动员是一种安全的方法;然而,plerixafor给药的比率较高,尝试失败,可能会质疑其对化学移植的优越性。
    UNASSIGNED: High-dose chemotherapy followed by autologous hematopoietic stem cell support is recommended in the treatment of eligible multiple myeloma (MM) patients. The aim of this study was to compare the efficacy and safety of steady-state versus chemotherapy-based stem cell mobilization in our Hungarian patient population.
    UNASSIGNED: The subjects were 210 MM patients who underwent stem cell mobilization procedure between 2018 and 2022. Solo granulocyte colony-stimulating factor (G-CSF) was administered in 104 cases, while 106 patients received chemotherapy which was followed by G-CSF administration. We evaluated the ratio of successful mobilizations, the amount of collected stem cells, the incidence of infections and cost-effectivity in the two groups.
    UNASSIGNED: In the steady-state group, there was a significantly higher need for plerixafor (45% vs. 13%, P < 0.001), unsuccessful stem cell mobilization was more frequent (11% vs. 3%, P = 0.024) and the mean amount of collected stem cells was lower (6.9 vs. 9.8 × 106, P < 0.001) than in the chemotherapy group. However, infections were less frequent (4% vs. 27%, P < 0.001) and the number of days spent in hospital was significantly lower (6 vs. 14 days, P < 0.001). Plerixafor was more frequently administered in those who had received lenalidomide or daratumumab than in those who had been treated with other regimens (41% vs. 23%, P = 0.007 and 78% vs. 23%, P < 0.001, respectively).
    UNASSIGNED: Steady-state mobilization is a safe method; however, the higher rate of plerixafor administration and unsuccessful attempts may question its superiority to chemomobilization.
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  • 文章类型: Journal Article
    目的:本研究旨在阐明粒细胞集落刺激因子(G-CSF)在肝细胞癌(HCC)进展中的作用,以及该物质对疾病基质内相关信号通路的影响。
    方法:裸鼠荷瘤试验用于检测肿瘤进展。使用免疫荧光技术定量这些样品中甘露糖/CD68和CD34/甘露糖的水平以及巨噬细胞中甘露糖和诱导型一氧化氮合酶(iNOS)的浓度。血管生成能力通过管形成试验进行评估,和G-CSF的蛋白表达,血管内皮生长因子(VEGF),转化生长因子-β(TGF-β),基质金属蛋白酶2和9(MMP2/9),含SH2的蛋白酪氨酸磷酸酶-2(SHP-2),磷酸化PI3K/总PI3K(P-PI3K/t-PI3K),磷酸化AKT/总AKT(P-AKT/t-AKT),通过蛋白质印迹分析在肿瘤组织和巨噬细胞中测量磷酸化mTOR/总mTOR(P-mTOR/t-mTOR)。
    结果:施用G-CSF导致肿瘤体积显著增大。巨噬细胞甘露糖表达在G-CSF治疗后显著升高,而iNOS水平明显下降。G-CSF显著增强VEGF的分泌,TGF-β,和肿瘤组织中的MMPs。巨噬细胞参数,在G-CSF预处理的条件培养基中孵育后,指示相对于对照增强的管成型能力,通过引入特异性抑制剂减轻的效果。此外,G-CSF组SHP-2表达显着降低,在所有荷瘤范例中,PI3K/AKT/mTOR途径蛋白的磷酸化水平均大幅升高。
    结论:G-CSF通过激活肿瘤相关巨噬细胞(TAM)内的PI3K/AKT/mTOR信号级联,表面上促进肝细胞癌的发展。
    OBJECTIVE: This investigation seeks to elucidate the role of the Granulocyte Colony-Stimulating Factor (G-CSF) in the progression of hepatocellular carcinoma (HCC), as well as the impact of the substance on related signaling pathways within the disease matrix.
    METHODS: Nude mouse tumor-bearing assay was used to detect tumor progression. Levels of Mannose/CD68 and CD34/Mannose within these samples and the concentrations of Mannose and inducible Nitric Oxide Synthase (iNOS) in macrophages were quantified using immunofluorescence techniques. The angiogenic capability was assessed via tube formation assays, and protein expressions of G-CSF, Vascular Endothelial Growth Factor (VEGF), Transforming Growth Factor-beta (TGF-β), Matrix Metalloproteinases 2 and 9 (MMP2/9), SH2-containing protein tyrosine phosphatase-2 (SHP-2), phosphorylated PI3K/total PI3K (P-PI3K/t-PI3K), phosphorylated AKT/total AKT (P-AKT/t-AKT), and phosphorylated mTOR/total mTOR (P-mTOR/t-mTOR) were measured through Western Blot analysis in both tumor tissues and macrophages.
    RESULTS: Administration of G-CSF resulted in a marked augmentation of tumor volume. Macrophage Mannose expression was significantly elevated upon G-CSF treatment, while iNOS levels were conspicuously diminished. G-CSF substantially enhanced the secretion of VEGF, TGF-β, and MMPs in tumor tissues. Macrophage parameters, following incubation in G-CSF pre-treated conditioned medium, indicated enhanced tube-forming capabilities relative to the control, an effect mitigated by the introduction of specific inhibitors. Furthermore, the G-CSF group exhibited a notable reduction in SHP-2 expression, alongside a substantial elevation in the phosphorylation levels of the PI3K/AKT/mTOR pathway proteins across all tumor-bearing paradigms.
    CONCLUSIONS: G-CSF ostensibly facilitates the advancement of hepatocellular carcinoma by activating the PI3K/AKT/mTOR signaling cascade within Tumor-Associated Macrophages (TAM).
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  • 文章类型: Journal Article
    一名81岁的前列腺癌患者(cT3aN0M0),他们已经接受了4年的激素治疗,并且保持了较低的前列腺特异性抗原水平,盆腔淋巴结转移。组织活检显示转移性淋巴结中前列腺癌的神经内分泌分化。因此,开始用卡铂+依托泊苷进行化疗。在第一道菜中,由于中性粒细胞计数下降至230/μl,非格司亭给药2天。在第二个课程中,在第4天给予pegfilgrastim作为预防。然而,在第二道菜的第10天,他开始发烧和疲劳。怀疑感染,使用抗生素,但未能改善他的症状.在第14天,普通计算机断层扫描显示主动脉炎症的迹象。鉴于即使经过一周的抗生素治疗也缺乏改善,类固醇治疗开始怀疑粒细胞集落刺激因子(G-CSF)诱导的主动脉炎,这迅速改善了他的症状。因此,当遇到在使用G-CSF药物进行化疗期间发烧对抗生素无反应的病例时,需要考虑G-CSF药物引起的主动脉炎症的鉴别诊断.
    An 81-year-old man with prostate cancer (cT3aN0M0), who had been undergoing hormonal therapy for 4 years and had maintained low prostate specific antigen levels, developed metastasized pelvic lymph nodes. A tissue biopsy revealed neuroendocrine differentiation of prostate cancer in the metastatic lymph nodes. Consequently, chemotherapy with carboplatin+etoposide was initiated. During the first course, filgrastim was administered for 2 days due to a drop in his neutrophil count to 230/μl. During the second course, pegfilgrastim was administered as prophylaxis on day 4. However, on day 10 of the second course, he started to develop a fever and fatigue. Suspecting infection, antibiotics were administered, but failed to ameliorate his symptoms. On day 14, plain computed tomography revealed signs of aortic inflammation. Given the lack of improvement even after one week of antibiotic therapy, steroid treatment was initiated on the suspicion of granulocyte colony-stimulating factor (G-CSF) -induced aortitis, which rapidly improved his symptoms. Therefore, when encountering a case in which a fever remains unresponsive to antibiotics during chemotherapy with G-CSF agents, a differential diagnosis of aortic inflammation caused by G-CSF agents needs to be considered.
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  • 文章类型: English Abstract
    Objective: To explore the efficacy and safety of cryopreservation-free integrated autologous hematopoietic stem cell transplantation (HSCT) model for patients with multiple myeloma. Methods: A total of 96 patients with newly diagnosed multiple myeloma (NDMM) between July 31, 2020, and December 31, 2022, were retrospectively analyzed, of which 41 patients in the observation group received integrated non-cryopreserved transplantation mode. After hematopoietic stem cells were mobilized and collected, melphalan was started immediately for pre-transplant conditioning, and non-cryopreserved grafts from the medical blood transfusion refrigerator were directly injected intravenously into the patient within 24-48 h after the melphalan conditioning. The control group consisted of 55 patients who received traditional transplantation mode. After hematopoietic stem cells were collected, stem cell cryopreservation was performed in liquid nitrogen, and then the transplant plans were started at the right time. All patients received mobilization of autologous hematopoietic stem cells using the G-CSF combined with the plerixafor. Results: ① A total of 34 patients (82.9% ) with VGPR plus CR in the observation group were significantly higher than 33 patients (60.0% ) in the control group (P=0.016). ②Compared with the control group, the incidence of grade 1 oral mucosal inflammation was higher in the observation group (P<0.001) ; however, the incidence of grades 2 and 3 oral mucosal inflammation was lower (P=0.004, P=0.048), and neither group experienced grade 4 or above oral mucosal inflammation. The incidence of grade 1 diarrhea was higher in the observation group (P=0.002), whereas the incidence of grade 3 diarrhea was lower (P=0.007). No statistically significant difference was observed in the incidence of grade 4 diarrhea (P=0.506), and neither group experienced grade 5 diarrhea. ③ The incidence of bacterial infection in the observation group was lower than that in the control group (34.1% vs 65.5%, P=0.002), whereas no statistically significant difference was observed in the incidence of fungal infection (29.3% vs 31.4%, P=0.863) and viral infection (4.88% vs 3.64%, P=0.831). ④No statistically significant difference was observed in the implantation time of granulocytes and platelets between the observation and control groups [10 (8-20) days vs 11 (8-17) days, P=0.501; 13 (10-21) days vs 15 (10-20) days, P=0.245]. ⑤ All patients did not receive lenalidomide treatment 100 days post-transplantation. At 30 days post-transplantation, the CTL, NK, and Th cell counts in the observation group were lower than those in the control group (P<0.001, P=0.002, P=0.049), and the NKT cell counts were higher than those in the control group (P=0.024). At 100 days post-transplantation, the CTL, NKT, and Th cell counts in the observation group were higher than those in the control group (P=0.025, P=0.011, P=0.007), and no statistically significant difference in NK cell counts was observed between the two groups (P=0.396). ⑥ The median follow-up was 18 (4-33) months. The overall 2-year survival rates of the observation and control groups post-transplantation were 91.5% and 78.2%, respectively (P=0.337). The recurrence-free survival rates were 85.3% and 77.6%, respectively (P=0.386), and the cumulative recurrence rates were 9.8% and 16.9%, respectively (P=0.373) . Conclusion: In NDMM, the cryopreservation-free integrated autologous HSCT model can achieve similar therapeutic effects as traditional transplantation models, with lower rates of severe mucosal inflammation and infection compared with traditional transplantation models.
    目的: 探讨无冻存一体化自体造血干细胞移植模式在多发性骨髓瘤(MM)患者中的疗效和安全性。 方法: 纳入2020年7月31日至2022年12月31日在电子科技大学附属医院四川省人民医院接受自体造血干细胞移植的新诊断多发性骨髓瘤(NDMM)患者96例,对其临床资料进行回顾性分析。41例患者接受无冻存一体化移植模式(观察组),造血干细胞动员采集后冷藏于医用输血冰箱(4 ℃)并立即启动美法仑预处理,预处理结束24 h后回输自体造血干细胞;55例患者接受传统移植模式(对照组),造血干细胞动员采集后液氮冷冻保存,择期启动移植流程。两组患者均采用G-CSF联合普乐沙福进行自体造血干细胞动员。 结果: ①观察组移植前疾病状态为非常好的部分缓解(VGPR)及完全缓解(CR)患者占比显著高于对照组[82.9%(34/41)对60.0%(33/55),P=0.016]。②与对照组相比,观察组1级口腔黏膜炎的发生率较高(P<0.001),但2、3级口腔黏膜炎的发生率较低(P=0.004,P=0.048),两组均未发生≥4级口腔黏膜炎;观察组1级腹泻的发生率较高(P=0.002),3级腹泻的发生率较低(P=0.007),4级腹泻的发生率差异无统计学意义(P=0.506),两组均未发生5级腹泻。③观察组细菌感染发生率低于对照组(34.1%对65.5%,P=0.002),真菌感染(29.3%对31.4%,P=0.863)、病毒感染(4.88%对3.64%,P=0.831)发生率差异无统计学意义。④观察组与对照组粒细胞植入时间和血小板植入时间差异无统计学意义[10(8~20)d对11(8~17)d,P=0.501;13(10~21)d对15(10~20)d,P=0.245]。⑤移植后100 d前所有患者均未使用来那度胺治疗。移植后30 d,观察组CTL、NK、Th细胞计数低于对照组(P<0.001,P=0.049,P=0.002),NKT细胞计数高于对照组(P=0.024)。移植后100 d,观察组CTL、NKT、Th细胞计数高于对照组(P=0.025,P=0.011,P=0.007),NK细胞计数两组差异无统计学意义(P=0.396)。⑥中位随访18(4~33)个月,观察组和对照组移植后2年总生存率分别为91.5%、78.2%(P=0.337),无复发生存率分别为85.3%、77.6%(P=0.386),累积复发率分别为9.8%、16.9%(P=0.373)。 结论: 无冻存一体化自体造血干细胞移植模式在NDMM中可获得与传统移植模式相似的疗效,重度黏膜炎和感染的发生率低于传统移植模式。.
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  • 文章类型: Journal Article
    Objective: The effect and safety of etoposide combined with G-CSF were compared with those of cyclophosphamide combined with G-CSF in autologous peripheral blood mobilization in patients with multiple myeloma (MM) . Methods: Patients with MM who received autologous peripheral blood stem cell mobilization and collection in the Department of Hematology, Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 1, 2020 to July 31, 2023 were included. A total of 134 patients were screened by propensity score matching technology according to a 1∶1 ratio. A total of 67 cases were each treated with ETO combined with G-CSF mobilization scheme (ETO group) and CTX combined with G-CSF mobilization scheme (CTX group). Their clinical data were retrospectively analyzed. Results: ①Collection results: the ETO and CTX groups [2 (1-3) d vs 2 (1-5) d; P<0.001] and CD34(+) cells [7.62×10(6) (2.26×10(6)-37.20×10(6)) /kg vs 2.73×10(6) (0.53×10(6)-9.85×10(6)) /kg; P<0.001] were collected. The success rate of collection was 100.0% (67/67) versus 76.1% (51/67) (P<0.001). Excellent rate of collection was 82.1% (55/67) versus 20.9% (14/67; P<0.001). Two patients in the ETO group switched protocols after 1 day of collection, and 11 patients in the CTX group switched protocols after 1-2 days of collection. ②Adverse reactions: granular deficiency with fever (21.5%[14/65] vs. 10.7%[6/56]; P=0.110), requiring platelet transfusion [10.7% (7/65) vs 1.8% (1/56) ; P=0.047]. ③Until the end of follow-up, 63 cases in the ETO group and 54 cases in the CTX group have undergone autologous transplantation. The median number of CD34(+) cells infused in the two groups was 4.62×10(6) (2.14×10(6)-19.89×10(6)) /kg versus 2.62×10(6) (1.12×10(6)-5.31×10(6)) /kg (P<0.001), neutrophil implantation time was 11 (9-14) d versus 11 (10-14) d (P=0.049), and platelet implantation time was 11 (0-19) d vs. 12 (0-34) d (P=0.035). One case in the CTX group experienced delayed platelet implantation. Conclusion: The mobilization scheme of etoposide combined with G-CSF requires relatively platelet transfusion, but the collection days are shortened. The collection success rate, excellent rate, and the number of CD34(+) cells obtained are high, and the neutrophil and platelet engraftment is accelerated after transplantation.
    目的: 比较依托泊苷(ETO)联合G-CSF与环磷酰胺(CTX)联合G-CSF在多发性骨髓瘤(MM)患者中进行自体外周血造血干细胞动员的效果及安全性。 方法: 纳入2020年1月1日至2023年7月31在首都医科大学附属北京朝阳医院血液科接受自体外周血造血干细胞动员、采集的MM患者,利用倾向性评分按照1∶1匹配比例筛选出134例患者,ETO联合G-CSF动员方案(ETO组)、CTX联合G-CSF动员方案(CTX组)各67例,对其临床资料进行回顾性分析。 结果: ①ETO组、CTX组采集天数分别为2(1~3)d、2(1~5)d(P<0.001),CD34(+)细胞采集量分别为7.62(2.26~37.20)×10(6)/kg、2.73(0.53~9.85)×10(6)/kg(P<0.001),采集成功率分别为100.0%(67/67)、76.1%(51/67)(P<0.001)、采集优良率分别为82.1%(55/67)、20.9%(14/67)(P<0.001)。ETO组有2例患者在采集1 d后进行方案转换,CTX组有11例患者在采集1~2 d后进行方案转换。②ETO组、CTX组粒缺伴发热发生率分别为21.5%(14/65)、10.7%(6/56)(P=0.110),血小板输注患者占比分别为10.7%(7/65)、1.8%(1/56)(P=0.047)。③至随访截止,ETO组63例、CTX组54例患者接受了自体造血干细胞移植,中位CD34(+)细胞回输量分别为4.62(2.14~19.89)×10(6)/kg、2.62(1.12~5.31)×10(6)/kg(P<0.001),中性粒细胞植入时间分别为11(9~14)d、11(10~14)d(P=0.049),血小板植入时间分别为11(0~19)d、12(0~34)d(P=0.035)。CTX组有1例患者发生血小板延迟植入。 结论: 依托泊苷联合G-CSF的动员方案可能有较多的患者需要输注血小板,但采集天数缩短,采集成功率、优良率及CD34(+)细胞采集量较高,移植后中性粒细胞和血小板植入较快。.
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  • 文章类型: Journal Article
    为了研究宫内灌注粒细胞集落刺激因子(G-CSF)对子宫内膜厚度的影响,volume,薄型子宫内膜患者的血流参数及其临床结局。
    我们设计了一项前瞻性非随机同步对照试验,招募了2021年9月1日至2023年9月1日在绵阳市中心医院接受冻融胚胎移植(FET)的子宫内膜薄型患者。他们被分成两组,实验组为接受G-CSF宫内灌注实验治疗的患者,对照组为未接受实验治疗的患者。分析比较两组患者的一般资料和临床治疗效果。子宫内膜厚度,分析实验组患者宫内灌注G-CSF前后的体积和血流参数。
    83例患者的临床资料纳入研究。实验组包括51例,对照组31例。两组之间的基线数据无显著差异。实验组临床妊娠率(56.86%)高于对照组(50.00%),自然流产率(27.59%)低于对照组(37.50%),但差异无统计学意义(P>0.05)。在实验组中,灌注后子宫内膜厚度([0.67±0.1]cm)大于灌注前子宫内膜厚度([0.59±0.09]cm),灌注后([1.84±0.81]cm3)大于灌注前子宫内膜体积([1.54±0.69]cm3),灌注后血管化血流指数(VFI)(1.97±2.82)大于灌注前VFI(0.99±1.04),差异均有统计学意义(P<0.05)。
    宫腔内灌注G-CSF可增强子宫内膜厚度,volume,子宫内膜薄型患者的一些血流参数。
    UNASSIGNED: To investigate the effects of intrauterine perfusion with granulocyte colony-stimulating factor (G-CSF) on the endometrial thickness, volume, and blood flow parameters of patients with thin endometrium and their clinical outcomes.
    UNASSIGNED: We designed a prospective non-randomized synchronous controlled trial and recruited patients with thin endometrium who underwent frozen-thawed embryo transfer (FET) at Mianyang Central Hospital between September 1, 2021 and September 1, 2023. They were divided into two groups, an experimental group of patients who received the experimental treatment of intrauterine perfusion with G-CSF and a control group of patients who did not receive the experimental treatment. The general data and the clinical outcomes of the two groups were analyzed and compared. The endometrial thickness, volume and blood flow parameters of patients in the experimental group before and after intrauterine perfusion with G-CSF were analyzed.
    UNASSIGNED: The clinical data of 83 patients were included in the study. The experimental group included 51 cases, while the control group included 31 cases. There were no significant differences in the baseline data between the two groups. The clinical pregnancy rate of the experimental group (56.86%) was higher than that of the control group (50.00%) and the rate of spontaneous abortion in the experimental group (27.59%) was lower than that in the control group (37.50%), but the differences were not statistically significant (P>0.05). In the experimental group, the postperfusion endometrial thickness ([0.67±0.1] cm) was greater than the preperfusion endometrial thickness ([0.59±0.09] cm), the postperfusion ([1.84±0.81] cm3) was greater than the preperfusion endometrial volume ([1.54±0.69] cm3), and the postperfusion vascularization flow index (VFI) (1.97±2.82) was greater than the preperfusion VFI (0.99±1.04), with all the differences being statistically significant (P<0.05).
    UNASSIGNED: Intrauterine perfusion with G-CSF can enhance the endometrial thickness, volume, and some blood flow parameters in patients with thin endometrium.
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  • 文章类型: Journal Article
    背景和目的:我们单中心队列研究的目的是确定子宫内灌洗粒细胞集落刺激生长因子(G-CSF)对植入失败病史超过40岁的患者临床妊娠率的影响。材料和方法:该研究于2018年5月至2020年6月在布拉格SEFerticare进行。总的来说,115名患者被分成两臂,有48名受试者在实验中,67名受试者在控制臂中。所有女性都有过不孕症治疗失败的历史,他们自己的遗传物质和至少一个无效周期与捐赠的卵母细胞。在胚胎移植前120至48小时,实验臂接受了0.5mL纯G-CSF的子宫内灌洗。结果:实验组的临床妊娠率为63.3%,对照组为47.8%(Pearsonsχ2p=0.097,Fisher精确检验p=0.133)。然而,胚胎移植当天的平均子宫内膜厚度没有统计学差异(p=0.139).只有子宫内膜厚度增长的差异有统计学意义(p=0.023)。怀孕率的提高对未来来说仍然令人鼓舞,即使它并不重要。结论:我们的研究表明,在胚胎移植前120-48小时内,宫内G-CSF灌洗后妊娠率有增加的趋势。
    Background and Objectives: The aim of our single-center cohort study was the determination of the influence of the intrauterine lavage of granulocyte colony-stimulating growth factor (G-CSF) on clinical pregnancy rate in patients with a history of implantation failure older than 40 years. Materials and Methods: The study was conducted in Ferticare Prague SE between May 2018 and June 2020. Overall, 115 patients were distributed into two arms, with 48 subjects in the experimental and 67 in the control arm. All women have had a previous history of unsuccessful history of infertility treatment with their own genetic material and at least one ineffective cycle with the donated oocytes. The experimental arm underwent the intrauterine lavage of 0.5 mL of pure G-CSF from 120 to 48 h prior to embryo transfer. Results: The clinical pregnancy rate was 63.3% in the experimental arm and 47.8% in the control arm (p = 0.097 for Pearsonߣs χ2, and p = 0.133 for Fisher\'s exact test). However, the mean endometrial thickness on the day of embryo transfer did not appear to be statistically different (p = 0.139). Only the difference in endometrium thickness growth was statistically significant (p = 0.023). The increase in pregnancy rate is still encouraging for the future, even if it is not significant. Conclusion: Our study suggests the trend of increased pregnancy rate after the intrauterine G-CSF lavage in the interval of 120-48 h prior to embryo transfer.
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  • 文章类型: English Abstract
    OBJECTIVE: To investigate the role of levofloxacin combined with recombinant human granulocyte colony-stimulating factor (G-CSF) or only G-CSF supportive therapy in preventing infection in autologous hematopoietic stem cell transplantation(ASCT), and to analyze the length of hospital stay, hospitalization cost and post-transplant survival of the patients.
    METHODS: A retrospective analysis was performed in the patients with hematological malignancies who accepted ASCT at our hospital from January 2012 to July 2022, the febrile neutropenia, the incidence of bacterial infection and the use rate of intravenous antibiotics in the levofloxacin+G-CSF group and only G-CSF support group during ASCT were observed. The length of hospital stay, total cost during hospitalization and survival after 90 days of transplantation between the two groups were compared.
    RESULTS: A total of 102 cases were included in this study, including 57 cases of multiple myeloma, 36 cases of acute leukaemia, 7 cases of lymphoma, 3 cases of myelodysplastic syndrome, 1 case of light chain amyloidosis, and 1 case of POEMS syndrome. 47 patients received levofloxacin+ G-CSF antibacterial prophylaxis, and 55 patients received G-CSF supportive therapy. In the levofloxacin+ G-CSF group, 40 cases (85.11%) developed febrile neutropenia, and 13 cases (27.66%) were confirmed as bacterial infection. In the G-CSF group, 44 cases (80.00%) developed febrile neutropenia, and 16 cases (29.09%) were bacterial infection. There was no statistically significant difference in the incidence of febrile neutropenia and bacterial infection between the two groups (χ2=0.46,P =0.50; χ2=0.03,P =0.87). The use rate of intravenous antibiotics in the levofloxacin+ G-CSF group was 85.11% (40/47), which was not statistically different from 85.45% (47/55) in the G-CSF group (χ2=0.04,P =0.84). The detection rates of levofloxacin-resistant bacteria in the levofloxacin+ G-CSF group and G-CSF group were 8.57% (3/35) and 21.43% (6/28), respectively, with no statistical difference (χ2=0.65, P >0.05). The median length and median cost of hospitalization in the levofloxacin+ G-CSF group and G-CSF group were 25 d vs 22 d and 78 216.24 yuan vs 80 724.38 yuan, with no statistically significant differences ( t =3.00,P =0.09; t =0.94,P =0.09). Within 90 days after transplantation, two cases (4.26%) died in the levofloxacin+ G-CSF group and one case (1.82%) died in the G-CSF group, with no statistically significant difference between the two groups (χ2=0.53,P =0.47).
    CONCLUSIONS: Application of levofloxacin+ G-CSF showed no significant benefit compared to G-CSF support for the prevention of bacterial infections during ASCT.
    UNASSIGNED: 左氧氟沙星联合G-CSF或仅用G-CSF支持疗法在预防自体造血干细胞移植感染中的作用.
    UNASSIGNED: 探讨重组人粒细胞集落刺激因子(G-CSF)联合左氧氟沙星或仅用G-CSF支持疗法在预防自体造血干细胞移植感染中的作用,分析移植患者住院时间、住院费用及移植后生存情况。.
    UNASSIGNED: 回顾性分析2012年1月至2022年7月于本院就诊的接受自体造血干细胞移植的恶性血液病患者,观察自体造血干细胞移植期间左氧氟沙星+G-CSF预防感染组和G-CSF支持组中性粒细胞缺乏伴发热、细菌感染发生率及静脉抗菌药物使用情况,并比较两组住院时间、住院期间总费用及移植90天后存活情况。.
    UNASSIGNED: 102例患者纳入研究,其中多发性骨髓瘤54例,急性白血病36例,淋巴瘤7例,骨髓增生异常综合征3例,轻链型淀粉样变性1例,POEMS综合征1例。47例接受G-CSF+左氧氟沙星预防感染,55例接受G-CSF支持治疗。左氧氟沙星+G-CSF组中40例(85.11%)发生中性粒细胞缺乏伴发热,13例(27.66%)明确为细菌感染。G-CSF组中44例(80.00%)发生中性粒细胞缺乏伴发热,16例(29.09%)细菌感染。两组中性粒细胞缺乏伴发热和细菌感染发生率均无统计学差异(χ2=0.46,P =0.50;χ2=0.03,P =0.87)。左氧氟沙星+G-CSF组静脉抗菌药物使用率为85.11%(40/47),与G-CSF组的85.45%(47/55)比较无统计学差异(χ2= 0.04,P =0.84)。左氧氟沙星+G-CSF组与G-CSF组左氧氟沙星耐药菌的检出率分别为8.57%(3/35)和21.43%(6/ 28),无统计学差异(χ2=0.65,P >0.05)。左氧氟沙星+G-CSF与G-CSF组患者住院中位时间为25 d vs 22 d,住院中位费用为78 216.24元 vs 80 724.38元,差异均无统计学意义( t =3.00,P =0.09; t =0.94,P =0.09)。移植后90天内,左氧氟沙星+G-CSF组有2例(4.26%)死亡,G-CSF组有1例(1.82%)死亡,两组比较无统计学差异(χ2=0.53,P =0.47)。.
    UNASSIGNED: 较G-CSF支持相比,患者在自体造血干细胞移植期间应用G-CSF+左氧氟沙星预防感染无明显获益。.
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  • 文章类型: Journal Article
    这项荟萃分析评估了预防性化疗后粒细胞集落刺激因子(G-CSF)对急性髓细胞性白血病(AML)患者的影响。总的来说,复发率,总生存率,无事件生存,G-CSF(+)与G-CSF(-)患者的死亡率相似.然而,与G-CSF(-)组相比,接受G-CSF治疗的儿童和继发性AML患者的相对复发风险(RR)更高[RR,95%置信区间:1.26、1.04-1.52和1.12(1.02-1.24)]。对于患有AML和继发性AML的儿科患者,应谨慎使用化疗后G-CSF治疗,因为这可能会增加复发风险。
    This meta-analysis evaluated the impact of prophylactic post-chemotherapy granulocyte colony-stimulating factor (G-CSF) in patients with acute myeloid leukemia (AML). Overall, the relapse rate, overall survival, event-free survival, and mortality rate were similar in G-CSF (+) compared to G-CSF (-) patients. However, the relative risk (RR) of relapse was higher in children and in secondary AML patients who were treated with G-CSF compared to the G-CSF (-) group [RR, 95% confidence interval: 1.26, 1.04-1.52, and 1.12 (1.02-1.24)]. Treatment with post-chemotherapy G-CSF should be prescribed with caution in pediatric patients with AML and secondary AML as possibly increasing the relapse risk.
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