摘要目的　研究异基因骨髓移植供者应用G-CSF对加速造血重建与减轻急性GVHD的影响及其生物学机制。方法　30例白血病异基因骨髓移植供者应用G-CSF为研究组，采髓前供者接受格拉诺赛特3-4 μg*kg-1*d-1,共7天。15例供者采髓前未用G-CSF为对照组。比较其促造血恢复和减轻急性重度GVHD的疗效。5例供者使用G-CSF前后进行了自身对比，观察G-CSF对骨髓中造血祖细胞和淋巴细胞亚群的影响。结果　与对照组比较，供者使用G-CSF后，在采集相同的骨髓量中含较多有核细胞、CFU-GM及CD34+数。加速造血重建，粒细胞计数>0.5×109/L与血小板>20×109/L分别为16.7±3.2与18.4±3.0(对照组是22.5±5.1与26.3±5.9天，P<0.01)。急性重度GVHD发生率低，急性Ⅱ-Ⅳ度GVHD发生率3.3%，仅1例出现Ⅱ度皮肤急性GVHD，对照组急性Ⅱ-Ⅳ度GVHD发生率26.7%(P>0.05)。供者应用G-CSF与未使用G-CSF对照组比较，CD34+百分率和CFU-GM增殖增加(P<0.01)，CD4+减少(P<0.05)，CD8+增加(P>0.05)。二组慢性GVHD与复发率比较无差异。结论　异基因骨髓移植供者G-CSF可加速造血重建，而且能减轻重度急性GVHD，供者应用G-CSF倾向改善移植相关死亡率。

abstractsObjectives　To investigate the efficacy of accelerating hemopoietic reconstraction and reducing a graft versus host disease (GVHD) in Allo-BMT receiving lenograstim stimulated donor marrow and to assess the preliminary biological mechanism .Methods　The donors for thirty patients (study group) with leukemia were given lenograstim 3-4?μg*kg-1*d-1 for seven days prior to marrow harvest. The results of subsequent engraftment in the recipients was compared with fifteen donors without G-CSF (control group). Five donors themselves were studied to assess the effects of lenograstion on hematopoietic progenitor cells and lymphocyte subsets in BM.Results　The stimulated bone marrow contained a higher number of nucleated cells, CFU-GM and CD34+ cells (P<0.01). The hematopoetic reconstitution was accelerated. Until granulocyte counts exceeded 0.5×109/L and plalete counts exceeded 20×109/L, the days were 16.7±3.2 and 18.4±3.0 days as compared with those of the control group (22.5±5.1 and 26.3±5.9 days respectively, P<0.01). The incidence of grade Ⅱ-Ⅳ aGVHD was very low, only one case with grade Ⅱ aGVHD on the skin in the study group. Four out of fifteen patients (26.7%) in the control group had grade Ⅱ-Ⅳ aGVHD (P<0.05). The number of T lymphocyte subsets in the harvested BM stimulated by G-CSF changed. In comparison with the control group, CD4+ decreased and CD8+ increased significantly (P<0.01). The changes of progenitor cells and T lymphocyte subsets in BM from pre- to post- G-CSF stimulation indicated that the percentage of CD4+ cells reduced (P<0.05), that of CD8+ cells, and that of CD34+ increased (P<0.01). The incidence of chronic GVHD and relapse of leukemia were not different significantly between both groups.Conclusions　Allogenic bone marrow transplant (Allo-BMT) donors given G-CSF can accelerate engraftment and minimize the incidence of severe aGVHD. There is a trend in favour of improved transplant-related complicatians.