ABSTRACT
Objective: To investigate the effect of subcutaneous injection of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) combined with intravenous drip of recombinant human interleukin-2 (rhIL-2) on radiation esophagitis in the patients with esophageal cancer undergoing radiotherapy. Methods: Seventy patients with esophageal cancer were randomly divided into the experimental group and the control group. Thirty-five patients in the experimental group were treated with subcutaneous injection of rhGM-CSF combined with intravenous drip of rhIL-2 and radiotherapy, while 35 patients in the control group were just treated with radiotherapy alone. The occurrence of radiation esophagitis, the degree of pain, intervention measures and treatment compliance were compared between the two groups. Results: There were 3 cases with grade 3 or 4 radiation esophagitis in the experimental group, and 12 cases in the control group (P < 0.05). The number of patients with swallowing pain (more than 7 points) caused by radiation esophagitis in the experimental group was significantly less than that in the control group (P < 0.05). The number of patients used the intervention drugs of radiation esophagitis in the experimental group was significantly less than that in the control group (P < 0.05). After the treatment, the nausea and vomiting, loss of appetite, pain, and insomnia in the experimental group were significantly better than those in the control group (all P < 0.05). There was no interruption of radiotherapy in the experimental group, while the radiotherapy of 3 cases in the control group was interrupted (P < 0.05). Conclusion: Subcutaneous injection of rhGM-CSF combined with intravenous drip of rhIL-2 significantly reduce the proportion of radiation esophagitis-related symptoms in the patients with esophageal cancer, improve the quality of life by reliving the swallowing pain, as well as improve the treatment compliance of patients.
ABSTRACT
ObjectiveTo evaluate the primary effect of granulocyte-monocyte colony stimulating factor (GM-CSF) as an immunotherapy option for treatment of residual disease after alloHSCT.Methods Immunotherapy was performed on two patients with blood malignancy to treat residual disease after allo-HSCT. The patient one,who was diagnosed as having MDS-RAEB Ⅱ,showed bone marrow displasis and incomplete chimerism 6 months after unrelated donor HSCT.Immunosuppressive drug was withdrawn without induction of graft-versus-host disease (GVHD).The patient two B-ALL demonstrated a residual disease at molecular level 30 days post-transplantation.Both of them were given GMCSF (300 μg) subcutaneously once every two days for totally three weeks.During the whole period,skin itch and rash,liver function,subgroups of lymphocytes,and MDSCs and DCs in peripheral blood were investigated.Results In case one,grade Ⅰskin acute GVHD (aGVHD) appeared as early as one week after GM-CSF administration,as well as grade Ⅱ (skin and liver) by the end of the third weeks,and GM-CSF injection was withdrawn.One month later since the start of GM-CSF,the patient showed normal bone marrow morphology and full donor type chimerism. Cyclosporine A (CsA), mycophenolate mofetil and methylprednisolone were administered for two weeks to control GVHD.In the other case,grade Ⅰ aGVHD occurred 9 days after GMCSF administration,and whole blood CsA maintained at 0.134-0.472 μmol/L.Prednisone (30mg per day for 5 days) was used to control grade Ⅱ GVHD from the 11th day after GM-CSF,and grade Ⅰ GVHD continued without any intervention.On the 30th day after GM-CSF treatment,bone marrow aspiration showed complete molecular remission.In both of the two cases,no differences in lymphocytic subtypes were revealed before and after GM-CSF administration,while there were trends of increased DC number and decreased MDSCs in peripheral blood.ConclusionThe administration of GM-CSF as an immunotherapy option for blood malignancy may contribute to the clearance of residual disease after Allo-HSCT.