普乐沙福联合G-CSF动员淋巴瘤患者自体外周血造血干细胞的疗效及安全性分析  

Efficacy and Safety of Plerixafor Combined with G-CSF for Autologous Peripheral Blood Hematopoietic Stem Cell Mobilization in Lymphoma Patients

作　　者：管方舒 何冬花[1] 李奕[1] 张仪[2] 郑高锋[1] 朱园园[1] 何静松[1] 张恩帆 蔡真[1] 赵毅[1] GUAN Fang-Shu;HE Dong-Hua;LI Yi;ZHANG Yi;ZHENG Gao-Feng;ZHU Yuan-Yuan;HE Jing-Song;ZHANG En-Fan;CAI Zhen;ZHAO Yi(Bone Marrow Transplantation Center,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang Province,China;Department of Hematology,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属第一医院骨髓移植中心,浙江杭州310006 [2]浙江大学医学院附属第一医院血液科,浙江杭州310006

出　　处：《中国实验血液学杂志》2023年第4期1056-1060,共5页Journal of Experimental Hematology

摘　　要：目的:分析普乐沙福联合粒细胞集落刺激因子(G-CSF)动员淋巴瘤患者自体外周血造血干细胞的有效性及安全性。方法:回顾性分析2019年1月到2021年12月接受普乐沙福联合G-CSF进行自体造血干细胞动员的淋巴瘤患者的临床资料。普乐沙福的用药策略分为一线稳态动员、抢先干预及挽救性动员,对三种策略的采集成功率、优良率及治疗相关不良反应率进行统计,并对性别、年龄、疾病缓解状态、初诊时是否有骨髓累及、化疗线数、化疗次数、采集前一天血小板数及采集前一天外周血CD34+细胞数等因素对采集结果的影响进行分析。结果:共纳入43例患者,其中7例为一线稳态动员,19例为抢先干预,17例为挽救性动员。使用普乐沙福联合G-CSF后,总体采集成功率为58.1%(25/43),一线稳态动员采集成功率为100%,抢先干预为57.9%(11/19),挽救性动员为41.2%(7/17)。采集优良率为18.6%(8/43)。共有15例患者出现轻中度治疗相关不良反应。采集前一天外周血CD34+细胞数<5个/μl是影响干细胞采集的独立危险因素。结论:普乐沙福联合G-CSF是淋巴瘤患者安全有效的动员方案。采集前一天外周血CD34+细胞数是预测干细胞采集的有效指标。Objective:To investigate the efficacy and safety of plerixafor combined with granulocyte colonystimulating factor(G-CSF)in mobilizing peripheral blood hematopoietic stem cells in patients with lymphoma.Methods:The clinical data of lymphoma patients who received autologous hematopoietic stem cell mobilization using plerixafor combined with G-CSF from January 2019 to December 2021 were retrospectively analyzed.The patients received 3 kinds of mobilization regimens:front-line steady-state mobilization,preemptive intervention,and recuse mobilization.The acquisition success rate,excellent rate of collection,and incidence of treatment-related adverse reaction were counted.The influence of sex,age,disease remission status,bone marrow involvement at diagnosis,chemotherapy lines,number of chemotherapy,platelet count and number of CD34^(+)cells on the day before acquisition in peripheral blood on the collection results were analyzed to identify the risk factors associated with poor stem cell collection.Results:A total of 43 patients with lymphoma were enrolled,including 7 cases who received front-line steady-state mobilization,19 cases who received preemptive intervention,and 17 cases who received recuse mobilization.The overall acquisition success rate was 58.1%(25/43)after use of plerixafor combined with G-CSF,and acquisition success rate of front-line steady-state mobilization,preemptive intervention,and recuse mobilization was 100%,57.9%(11/19),and 41.2%(7/17),respectively.The excellent rate of collection was 18.6%(8/43).A total of 15 patients experienced mild to moderate treatment-related adverse reactions.The number of CD34^(+)cells<5 cells/μl in peripheral blood on the day before collection was an independent risk factor affecting stem cell collection.Conclusions:Plerixafor combined with G-CSF is a safe and effective mobilization regimen for patients with lymphoma.The number of CD34^(+)cells in peripheral blood on the day before collection is an predictable index for the evaluation of stem cell collection.

关 键 词：普乐沙福 淋巴瘤 外周血造血干细胞 造血干细胞动员 CD34 

分 类 号：R457.7[医药卫生—治疗学]