粒细胞集落刺激因子治疗急性淋巴细胞白血病疗效和安全性的系统评价_《中国循证医学杂志》

作者：

李培 ,  席亚明 , 徐建旺 , 张豪 , 李明 , 邓伟

兰州大学第一医院血液科，血液学研究所（兰州 730000）;

关键词：

粒细胞集落刺激因子急性淋巴细胞白血病 Meta分析系统评价

DOI：

10.7507/1672-2531.20100530

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的系统评价粒细胞集落刺激因子（G-CSF）对急性淋巴细胞白血病（ALL）患者的疗效和安全性。
方法计算机检索Cochrane Library、PubMed、EMbase、中国期刊全文数据库和维普中文科技期刊数据库，检索时间2000年1月～2009年10月。纳入G-CSF治疗急性淋巴细胞白血病的随机对照研究。按Cochrane 系统评价方法评价纳入研究的方法学质量和提取有效数据，用RevMan 5.0软件对总体生存率、诱导化疗结束后的完全缓解率、生存质量、感染情况、复发率、不良反应等进行Meta分析。
结果共纳入6个随机对照试验，共620例患者，研究质量均为C级。Meta分析结果显示G-CSF组在成人ALL总体生存率［RR=2.24，95%CI（1.28，3.90），P=0.004］方面优于对照组。
结论 G-CSF可提高成人ALL患者的总体生存率，尚不能证明其有提高完全缓解率、改善生存质量、减少感染情况、降低复发率的作用，有待进一步研究证实。

引用本文： 李培,席亚明,徐建旺,张豪,李明,邓伟. 粒细胞集落刺激因子治疗急性淋巴细胞白血病疗效和安全性的系统评价. 中国循证医学杂志, 2010, 10(8): 985-990. doi: 10.7507/1672-2531.20100530 复制

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2.	秘营昌, 王建祥. 我国急性白血病的诊断治疗现状. 国际输血及血液学杂志, 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.
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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, 万朝敏, 舒敏, 等. 集落刺激因子在小儿急性淋巴细胞白血病中应用的系统评价证据. 临床儿科杂志, 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.	秘营昌, 卞寿庚. 见: 张之南, 沈悌, 主编. 血液病诊断及疗效标准. 第三版. 北京: 科学出版社, 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.	刘秋玲, 杨玉兰, 马伏英, 等. 重组人粒细胞集落刺激因子在小儿急性淋巴细胞白血病化疗中的应用. 武警医学, 2001, 12(1): 10-12.
23.	何静, 陈燕, 舒文秀. Dvclp方案联用粒细胞集落刺激因子对成人急性淋巴细胞白血病诱导缓解治疗的临床研究. 临床内科杂志, 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.	史明丽, 编译. 癌症领域中生存质量的定义、目的及测定方法. 国外医学社会医学分册, 1996, 13(2): 68-73.

1. Pui CH. Childhood leukemias. N Engl J Med, 1995, 332(24): 1618-1630.
2. 秘营昌, 王建祥. 我国急性白血病的诊断治疗现状. 国际输血及血液学杂志, 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, 万朝敏, 舒敏, 等. 集落刺激因子在小儿急性淋巴细胞白血病中应用的系统评价证据. 临床儿科杂志, 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. 秘营昌, 卞寿庚. 见: 张之南, 沈悌, 主编. 血液病诊断及疗效标准. 第三版. 北京: 科学出版社, 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. 刘秋玲, 杨玉兰, 马伏英, 等. 重组人粒细胞集落刺激因子在小儿急性淋巴细胞白血病化疗中的应用. 武警医学, 2001, 12(1): 10-12.
23. 何静, 陈燕, 舒文秀. Dvclp方案联用粒细胞集落刺激因子对成人急性淋巴细胞白血病诱导缓解治疗的临床研究. 临床内科杂志, 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. 史明丽, 编译. 癌症领域中生存质量的定义、目的及测定方法. 国外医学社会医学分册, 1996, 13(2): 68-73.

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《中国循证医学杂志》

粒细胞集落刺激因子治疗急性淋巴细胞白血病疗效和安全性的系统评价

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