普乐沙福或环磷酰胺联合G-CSF在多发性骨髓瘤外周血干细胞动员中的有效性比较  

Comparison of Plerixafor or Cyclophosphamide Combined with G-CSF in Mobilization of Peripheral Blood Stem Cells in Multiple Myeloma

作　　者：李婉婷 马梁明[1] 连玉 王权钢 高中杰 赵爽 LI Wan-Ting;MA Liang-Ming;LIAN Yu;WANG Quan-Gang;GAO Zhong-Jie;ZHAO Shuang(Department of Hematology,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan,030032,Shanxi Province,China)

机构地区：[1]山西医科大学第三医院(山西白求恩医院山西医学科学院同济山西医院)血液科,山西太原030032

出　　处：《中国实验血液学杂志》2023年第5期1403-1409,共7页Journal of Experimental Hematology

基　　金：国家自然科学基金项目(82100145)。

摘　　要：目的:对比分析普乐沙福(PXF)联合粒细胞集落刺激因子(G-CSF)(PXF+G-CSF)与环磷酰胺(Cy)联合G-CSF(Cy+G-CSF)在多发性骨髓瘤外周血干细胞动员中的有效性。方法:回顾分析2019年1月至2021年12月在山西白求恩医院采用PXF+G-CSF(18例)或Cy+G-CSF(23例)进行外周血干细胞动员的多发性骨髓瘤患者的临床资料,包括采集获得CD34^(+)细胞数、采集成功率、采集失败率及采集优良率,分析患者性别、年龄、疾病类型、DS分期、ISS分期、既往化疗疗程数、动员前疾病状态及动员方式等因素与采集结果之间的关系,并对两种动员方案的不良反应、住院天数与经济负担进行比较。结果:41例患者共进行了97次动员采集,采集CD34^(+)细胞中位数为6.09(0-34.07)×10^(6)/kg,采集成功率、优良率和失败率分别为90.2%、56.1%和9.8%。单因素分析显示,性别、年龄、疾病分型及疾病分期与采集获得CD34^(+)细胞数及采集成功率无显著相关性(P>0.05),但动员前疾病缓解程度达到部分缓解以上者更易获得较高的CD34^(+)细胞数(P<0.05);PXF+G-CSF组在首次采集获得CD34^(+)细胞数、首次采集成功率上均显著优于Cy+G-CSF组(均P<0.05),且动员期间感染风险低、住院周期短(均P<0.05),但经济负担较重(P<0.05)。结论:PXF+G-CSF用于多发性骨髓瘤患者外周血干细胞动员时,首次采集成功率高,所获干细胞数目多,所需采集次数少,住院周期短,但费用相对较高。Objective:To compare the efficacy of plerixafor(PXF)combined with granulocyte colony-stimulating factor(G-CSF)(PXF+G-CSF)and cyclophosphamide(Cy)combined with G-CSF(Cy+G-CSF)in the mobilization of peripheral blood stem cells(PBSCs)in patients with multiple myeloma(MM).Methods:The clinical data of 41 MM patients who underwent PBSC mobilization using PXF+G-CSF(18 cases)or Cy+G-CSF(23 cases)in Shanxi Bethune Hospital from January 2019 to December 2021 were retrospectively analyzed,including the count of collected CD34^(+)cells,acquisition success rate,failure rate,and optimal rate.The correlation of sex,age,disease type,DS staging,ISS staging,number of chemotherapy cycle,disease status before mobilization,and mobilization regimen with the collection results was analyzed,and the adverse reactions,length of hospital stay,and hospitalization costs were compared between the two mobilization regimens.Results:The 41 patients underwent 97 mobilization collections,and the median number of CD34^(+)cells collected was 6.09(0-34.07)×10^(6)/kg.The acquisition success rate,optimal rate,and failure rate was 90.2%,56.1%,and 9.8%,respectively.Univariate analysis showed that sex,age,disease type,and disease stage had no significant correlation with the number of CD34^(+)cells collected and acquisition success rate(P>0.05),but the patients with better disease remission than partial remission before mobilization were more likely to obtain higher CD34^(+)cell count(P<0.05).The PXF+G-CSF group had a larger number of CD34^(+)cells and higher acquisition success rate in the first collection than Cy+G-CSF group(both P<0.05),and had lower infection risk and shorter length of hospital stay during mobilization(both P<0.05),but the economic burden increased(P<0.05).Conclusion:PXF+G-CSF used for PBSC mobilization in MM patients has high first acquisition success rate,large number of CD34^(+)cells,less number of collection times,and short length of hospital stay,but the economic cost is heavy.

关 键 词：多发性骨髓瘤 普乐沙福 环磷酰胺 外周血干细胞 干细胞动员 

分 类 号：R733.3[医药卫生—肿瘤]