Schwere angeborene Neutropenie: Neue Aspekte der Diagnostik und Therapie

Schwere angeborene Neutropenie: Neue Aspekte der Diagnostik und Therapie
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中性粒细胞减少症:诊断和治疗的新阿斯佩克特

DOI:
10.1055/s-2000-9668
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发表时间:
2000
期刊:
Klin Pädiatr
影响因子:
--
通讯作者:
K. Welte
K. Welte
中科院分区:
--
文献类型:
--
作者:
C. Zeidler;B. Schwinzer;K. Welte

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严重先天性中性粒细胞减少症(CN; Kostmann综合征)是一种血液系统疾病,其特征是在早幼粒细胞/中幼粒细胞发育阶段骨髓生成成熟停滞。这种停滞导致严重的中性粒细胞减少症,中性粒细胞绝对计数(ANC)低于0.2 × 10 9 /l,与婴儿早期严重的全身性细菌感染相关。自1994年以来,严重慢性中性粒细胞增多症国际登记处(SCNIR)收集的300多名CN患者的数据表明,这些患者中>90%对重组人粒细胞集落刺激因子(rHuG-CSF)治疗有反应,ANC >1.0 x 10 9 /l。在这些患者中,需要每日皮下注射rHuG-CSF,个体剂量范围为0.27 - 120 mcg/kg/d,以维持ANC高于1.0 × 10 9 /l。Adverse.events记录的这组患者的症状包括脾肿大、血小板减少症、骨质疏松症和恶性转化为MDS/白血病。rHuG-CSF治疗是否以及如何影响这些不良事件仍不清楚,因为没有历史对照进行比较。对于那些对rHuG-CSF治疗难治性并且继续患有严重且通常危及生命的细菌感染的患者,造血干细胞移植(HSCT)仍然是目前唯一可用的治疗方法。
Severe congenital neutropenia (CN; Kostmann syndrome) is a hematologic disorder characterized by a maturation arrest of myelopoiesis at the promyelocyte/myelocyte stage of development. This arrest results in severe neutropenia with absolute neutrophil counts (ANC) less than 0.2 x 10 9 /l associated with severe systemic bacterial infections from early infancy. Data on over 300 patients with CN collected by the Severe Chronic Neutropenia International Registry (SCNIR) since 1994 indicate that >90% of these patients respond to recombinant human granulocyte-colony stimulating factor (rHuG-CSF) treatment with an ANC >1.0 x 10 9 /l. In these patients rHuG-CSF is required daily as subcutaneous injection with individual doses ranging between 0.27 and 120 mcg/kg/day to maintain ANC above 1.0 × 10 9 /l. Adverse.events documented in this group of patients include splenomegaly, thrombocytopenia, osteoporosis and malignant transformation into MDS/leukemia. If and how rHuG-CSF treatment impacts on these adverse events remains unclear since there are no historical controls for comparison. For those patients who are refractory to rHuG-CSF treatment and continue to have severe and often life-threatening bacterial infections, hematopoietic stem cell transplantation (HSCT) is still the only currently available treatment.
DOI: 10.1056/nejm198906153202402
发表时间: 1989-06-15
影响因子: 158.5
作者:
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重组人粒细胞集落刺激因子(非格司亭)治疗严重慢性中性粒细胞减少症的随机对照 III 期试验。
DOI: --
发表时间: 1993
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影响因子: 20.3
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发表时间: 2000-10-01
期刊: BLOOD
影响因子: 20.3
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DOI: 10.1126/science.2420009
发表时间: 1986-04-04
期刊: SCIENCE
影响因子: 56.9
作者:
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