粒細胞集落刺激因子治療急性淋巴細胞白血病療效和安全性的系統評價_《中國循證醫學雜志》

作者：

李培 ,  席亞明 , 徐建旺 , 張豪 , 李明 , 鄧偉

蘭州大學第一醫院血液科，血液學研究所（蘭州?730000）;

關鍵詞：

粒細胞集落刺激因子急性淋巴細胞白血病 Meta分析系統評價

DOI：

10.7507/1672-2531.20100530

視頻：

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目的 ?系統評價粒細胞集落刺激因子（G-CSF）對急性淋巴細胞白血病（ALL）患者的療效和安全性。
方法 ?計算機檢索Cochrane Library、PubMed、EMbase、中國期刊全文數據庫和維普中文科技期刊數據庫，檢索時間2000年1月～2009年10月。納入G-CSF治療急性淋巴細胞白血病的隨機對照研究。按Cochrane 系統評價方法評價納入研究的方法學質量和提取有效數據，用RevMan 5.0軟件對總體生存率、誘導化療結束后的完全緩解率、生存質量、感染情況、復發率、不良反應等進行Meta分析。
結果 ?共納入6個隨機對照試驗，共620例患者，研究質量均為C級。Meta分析結果顯示G-CSF組在成人ALL總體生存率［RR=2.24，95%CI（1.28，3.90），P=0.004］方面優于對照組。
結論 ?G-CSF可提高成人ALL患者的總體生存率，尚不能證明其有提高完全緩解率、改善生存質量、減少感染情況、降低復發率的作用，有待進一步研究證實。

引用本文： 李培,席亞明,徐建旺,張豪,李明,鄧偉. 粒細胞集落刺激因子治療急性淋巴細胞白血病療效和安全性的系統評價. 中國循證醫學雜志, 2010, 10(8): 985-990. doi: 10.7507/1672-2531.20100530 復制

1.	Pui CH. Childhood leukemias. N Engl J Med, 1995, 332(24): 1618-1630.
2.	秘營昌, 王建祥. 我國急性白血病的診斷治療現狀. 國際輸血及血液學雜志, 2006, 29(04): 290-291.
3.	Mortuza FY, Papaioannou M, Moreira M. Minimal residual disease tests provide an independent predictor of clinical outcome in adult acute lymphoblastic leukemia. J Clin Oncol, 2002, 20(4): 1094-1104.
4.	Schrappe M, Reiter A, Zimmermann M, et al. Long-term results of four consecutive trials in childhood ALL performed by the ALL-BFM study group from 1981 to 1995. Berlin-Frankfurt-Munster. Leukemia, 2000, 14(12): 2205-2222.
5.	Bronchud MH, Potter MR, Morgenstern G, et al. In vitro and in vivo analysis of the effects of recombinant human granulocyte colony-stimulating factor in patients. Br J Cancer, 1988, 58(1): 64-69.
6.	Crawford J, Ozer H, Stoller R, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N Engl J Med, 1991, 325(3): 164-170.
7.	Chen SH, Liang DC, Liu HC. High-dose cytarabine-containing chemotherapy with or without granulocyte colony-stimulating factor for children with acute leukemia. Am J Hematol, 1998, 58(1): 20-23.
8.	Lifton R, Bennett JM. Clinical use of granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor in neutropenia associated with malignancy. Hematol Oncol Clin North Am, 1996, 10(4): 825-839.
9.	Laver J, Amylon M, Desai S, et al. Randomized trial of r-metHu granulocyte colony-stimulating factor in an intensive treatment for T-cell leukemia and advanced-stage lymphoblastic lymphoma of childhood: a pediatric oncology group pilot study. J Clin Oncol, 1998, 16(2): 522-526.
10.	Pui CH, Boyett JM, Hughes WT, et al. Human granulocyte colony-stimulating factor after induction chemotherapy in children with acute lymphoblastic leukemia. N Engl J Med, 1997, 336(25): 1781-1787.
11.	Little MA, Morland B, Chisholm J, et al. A randomised study of prophylactic G-CSF following MRC UKALL XI intensification regimen in childhood ALL and T-NHL. Med Pediatr Oncol, 2002, 38(2): 98-103.
12.	Elting LS, Cantor SB. Outcomes and costs of febrile neutropenia: adventures in the science and art of treatment choices. Support Care Cancer, 2002, 10(3): 189-196.
13.	Sasse EC, Sasse AD, Brandalise SR, et al. Colony-stimulating factors for prevention of myelosuppressive therapy-induced febrile neutropenia in children with acute lymphoblastic leukaemia. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD004139. DOI: 10.1002/14651858.CD004139.pub2.
14.	范娟, 萬朝敏, 舒敏, 等. 集落刺激因子在小兒急性淋巴細胞白血病中應用的系統評價證據. 臨床兒科雜志, 2006, 24(02): 147-149.
15.	Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol, 1976, 33(4): 451-458.
16.	秘營昌, 卞壽庚. 見: 張之南, 沈悌, 主編. 血液病診斷及療效標準. 第三版. 北京: 科學出版社, 2007: 116-121.
17.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
18.	Michel G, Landman-Parker J, Auclerc MF, et al. Use of recombinant human granulocyte colony-stimulating factor to increase chemotherapy dose-intensity: a randomized trial in very high-risk childhood acute lymphoblastic leukemia. J Clin Oncol, 2000, 18(7): 1517-1524.
19.	Holowiecki J, Giebel S, Krzemien S, et al. G-CSF administered in time-sequenced setting during remission induction and consolidation therapy of adult acute lymphoblastic leukemia has beneficial influence on early recovery and possibly improves long-term outcome: a randomized multicenter study. Leuk Lymphoma, 2002, 43(2): 315-325.
20.	Heath JA, Steinherz PG, Altman A, et al. Human granulocyte colony-stimulating factor in children with high-risk acute lymphoblastic leukemia: a Children’s Cancer Group Study. J Clin Oncol, 2003, 21(8): 1612-1617.
21.	Thomas X, Boiron JM, Huguet F, et al. Efficacy of granulocyte and granulocyte-macrophage colony-stimulating factors in the induction treatment of adult acute lymphoblastic leukemia: a multicenter randomized study. Hematol J, 2004, 5(5): 384-394.
22.	劉秋玲, 楊玉蘭, 馬伏英, 等. 重組人粒細胞集落刺激因子在小兒急性淋巴細胞白血病化療中的應用. 武警醫學, 2001, 12(1): 10-12.
23.	何靜, 陳燕, 舒文秀. Dvclp方案聯用粒細胞集落刺激因子對成人急性淋巴細胞白血病誘導緩解治療的臨床研究. 臨床內科雜志, 2006, 23(7): 467-469.
24.	Steinherz PG, Gaynon P, Miller DR, et al. Improved disease-free survival of children with acute lymphoblastic leukemia at high risk for early relapse with the New York regimen--a new intensive therapy protocol: a report from the Childrens Cancer Study Group. J Clin Oncol, 1986, 4(5): 744-752.
25.	Steinherz PG, Redner A, Steinherz L, et al. Development of a new intensive therapy for acute lymphoblastic leukemia in children at increased risk of early relapse. The Memorial Sloan-Kettering-New York-II protocol. Cancer, 1993, 72(10): 3120-3130.
26.	Sung L, Klaassen RJ, Dix D, et al. Identification of paediatric cancer patients with poor quality of life. Br J Cancer, 2009, 100(1): 82-88.
27.	史明麗, 編譯. 癌癥領域中生存質量的定義、目的及測定方法. 國外醫學社會醫學分冊, 1996, 13(2): 68-73.

1. Pui CH. Childhood leukemias. N Engl J Med, 1995, 332(24): 1618-1630.
2. 秘營昌, 王建祥. 我國急性白血病的診斷治療現狀. 國際輸血及血液學雜志, 2006, 29(04): 290-291.
3. Mortuza FY, Papaioannou M, Moreira M. Minimal residual disease tests provide an independent predictor of clinical outcome in adult acute lymphoblastic leukemia. J Clin Oncol, 2002, 20(4): 1094-1104.
4. Schrappe M, Reiter A, Zimmermann M, et al. Long-term results of four consecutive trials in childhood ALL performed by the ALL-BFM study group from 1981 to 1995. Berlin-Frankfurt-Munster. Leukemia, 2000, 14(12): 2205-2222.
5. Bronchud MH, Potter MR, Morgenstern G, et al. In vitro and in vivo analysis of the effects of recombinant human granulocyte colony-stimulating factor in patients. Br J Cancer, 1988, 58(1): 64-69.
6. Crawford J, Ozer H, Stoller R, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N Engl J Med, 1991, 325(3): 164-170.
7. Chen SH, Liang DC, Liu HC. High-dose cytarabine-containing chemotherapy with or without granulocyte colony-stimulating factor for children with acute leukemia. Am J Hematol, 1998, 58(1): 20-23.
8. Lifton R, Bennett JM. Clinical use of granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor in neutropenia associated with malignancy. Hematol Oncol Clin North Am, 1996, 10(4): 825-839.
9. Laver J, Amylon M, Desai S, et al. Randomized trial of r-metHu granulocyte colony-stimulating factor in an intensive treatment for T-cell leukemia and advanced-stage lymphoblastic lymphoma of childhood: a pediatric oncology group pilot study. J Clin Oncol, 1998, 16(2): 522-526.
10. Pui CH, Boyett JM, Hughes WT, et al. Human granulocyte colony-stimulating factor after induction chemotherapy in children with acute lymphoblastic leukemia. N Engl J Med, 1997, 336(25): 1781-1787.
11. Little MA, Morland B, Chisholm J, et al. A randomised study of prophylactic G-CSF following MRC UKALL XI intensification regimen in childhood ALL and T-NHL. Med Pediatr Oncol, 2002, 38(2): 98-103.
12. Elting LS, Cantor SB. Outcomes and costs of febrile neutropenia: adventures in the science and art of treatment choices. Support Care Cancer, 2002, 10(3): 189-196.
13. Sasse EC, Sasse AD, Brandalise SR, et al. Colony-stimulating factors for prevention of myelosuppressive therapy-induced febrile neutropenia in children with acute lymphoblastic leukaemia. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD004139. DOI: 10.1002/14651858.CD004139.pub2.
14. 范娟, 萬朝敏, 舒敏, 等. 集落刺激因子在小兒急性淋巴細胞白血病中應用的系統評價證據. 臨床兒科雜志, 2006, 24(02): 147-149.
15. Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol, 1976, 33(4): 451-458.
16. 秘營昌, 卞壽庚. 見: 張之南, 沈悌, 主編. 血液病診斷及療效標準. 第三版. 北京: 科學出版社, 2007: 116-121.
17. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
18. Michel G, Landman-Parker J, Auclerc MF, et al. Use of recombinant human granulocyte colony-stimulating factor to increase chemotherapy dose-intensity: a randomized trial in very high-risk childhood acute lymphoblastic leukemia. J Clin Oncol, 2000, 18(7): 1517-1524.
19. Holowiecki J, Giebel S, Krzemien S, et al. G-CSF administered in time-sequenced setting during remission induction and consolidation therapy of adult acute lymphoblastic leukemia has beneficial influence on early recovery and possibly improves long-term outcome: a randomized multicenter study. Leuk Lymphoma, 2002, 43(2): 315-325.
20. Heath JA, Steinherz PG, Altman A, et al. Human granulocyte colony-stimulating factor in children with high-risk acute lymphoblastic leukemia: a Children’s Cancer Group Study. J Clin Oncol, 2003, 21(8): 1612-1617.
21. Thomas X, Boiron JM, Huguet F, et al. Efficacy of granulocyte and granulocyte-macrophage colony-stimulating factors in the induction treatment of adult acute lymphoblastic leukemia: a multicenter randomized study. Hematol J, 2004, 5(5): 384-394.
22. 劉秋玲, 楊玉蘭, 馬伏英, 等. 重組人粒細胞集落刺激因子在小兒急性淋巴細胞白血病化療中的應用. 武警醫學, 2001, 12(1): 10-12.
23. 何靜, 陳燕, 舒文秀. Dvclp方案聯用粒細胞集落刺激因子對成人急性淋巴細胞白血病誘導緩解治療的臨床研究. 臨床內科雜志, 2006, 23(7): 467-469.
24. Steinherz PG, Gaynon P, Miller DR, et al. Improved disease-free survival of children with acute lymphoblastic leukemia at high risk for early relapse with the New York regimen--a new intensive therapy protocol: a report from the Childrens Cancer Study Group. J Clin Oncol, 1986, 4(5): 744-752.
25. Steinherz PG, Redner A, Steinherz L, et al. Development of a new intensive therapy for acute lymphoblastic leukemia in children at increased risk of early relapse. The Memorial Sloan-Kettering-New York-II protocol. Cancer, 1993, 72(10): 3120-3130.
26. Sung L, Klaassen RJ, Dix D, et al. Identification of paediatric cancer patients with poor quality of life. Br J Cancer, 2009, 100(1): 82-88.
27. 史明麗, 編譯. 癌癥領域中生存質量的定義、目的及測定方法. 國外醫學社會醫學分冊, 1996, 13(2): 68-73.

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《中國循證醫學雜志》

粒細胞集落刺激因子治療急性淋巴細胞白血病療效和安全性的系統評價

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