普乐沙福联合G-CSF在系统性轻链型淀粉样变性行自体外周血干细胞移植中的应用  

Application of Plerixafor combined with G-CSF in autologous stem cell transplantation in light chain amyloidosis

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作  者:董艳 艾燕 杨洪霞 DONG Yan;AI Yan;YANG Hongxia(National Clinical Center for Kidney Disease,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区:[1]东部战区总医院国家肾脏疾病临床医学研究中心,全军肾脏病研究所,南京210002

出  处:《医学研究与战创伤救治》2024年第1期69-71,共3页Journal of Medical Research & Combat Trauma Care

摘  要:目的分析普乐沙福联合粒细胞集落刺激因子(G-CSF)对系统性轻链型淀粉样变性(AL型淀粉样变性)行自体外周血干细胞移植(ASCT)中的有效性及安全性。方法选择2022年11月至2023年10月在某医院国家肾脏疾病临床医学研究中心使用普乐沙福联合G-CSF动员方案进行ASCT的32例AL型淀粉样变性患者,分析其基线临床资料、干细胞采集、造血重建、动员相关不良反应情况。结果32例AL型淀粉样变性患者使用普乐沙福联合G-CSF动员3~5 d后,采集前CD34+细胞计数及采集物CD34+细胞数分别为106.00(80.25,180.25)个/μL和(6.73±3.62)×10^(6)/kg;32例患者中有31例第1天采集合格,21例患者第1天采集优良,32例患者均采集成功,单次采集合格率96.88%,单次采集优良率65.63%,采集成功率100%;粒系植入中位时间9(9,10)d,血小板植入中位时间10(9,11)d,粒缺中位时长5(4,5)d,32例患者均顺利完成造血重建;动员相关不良反应情况为腹痛腹泻17例(53.13%)、骨骼肌肉酸痛10例(31.25%)、恶心呕吐5例(15.63%)、面部发麻2例(6.25%)、胸闷1例(3.13%),均为1、2级,对症处理后快速缓解,轻微可控。结论普乐沙福联合G-CSF动员方案应用于AL型淀粉样变性行ASCT是安全有效的。Objective To analyze the efficacy and safety of thetherapy of Plerixafor combined with granulocyte colony-stimulating factor(G-CSF)for light chain amyloidosis(AL amyloidosis)in autologous stem cell transplantation(ASCT).Methods A total of 32 patients with AL amyloidosis who underwent ASCT using the combination of Plerixafor and G-CSF mobilization protocol at a National Center for Clinical Medical Research in Kidney Diseases from November 2022 to October 2023 were selected.Their baseline clinical data,collection of stem cell,hematopoietic reconstitution,and related adverse reactions were analyzed.Results In the 32 patients with AL type amyloidosis,after 3-5 days of mobilization with Plerixafor combined with G-CSF,the pre-collection CD34+cell count and the collected CD34+cell count were 106.00(80.25,180.25)/uL and(6.73±3.62),respectively×10^(6)/kg.Among 32 patients,31 patients were qualified for collection on the first day,21 patients had excellent collection on the first day,and 32 patients were all collected successfully.The single collection pass rate was 96.88%,the single collection excellent rate was 65.63%,and the collection success rate was 100%;The median time for granulocyte implantation was 9(9,10)days,the median time for platelet implantation was 10(9,11)days,and the median time for neutropenia was 5(4,5)days.All 32 patients successfully completed hematopoietic reconstruction.The adverse reactions related to mobilization were abdominal pain and diarrhea in 17 cases(53.13%),skeletal andmuscle soreness in 10 cases(31.25%),nausea and vomiting in 5 cases(15.63%),facial numbness in 2 cases(6.25%),and chest tightness in 1 case(3.13%),all of which were grade 1 and 2.The adverse reactions are mild and controllable,and the patients received rapid relief after symptomatic treatment.Conclusion The application of Plerixafor combined with G-CSF in autologous stem cell transplantation in light chain amyloidosis is effective and safe.

关 键 词:系统性轻链型淀粉样变性 自体外周血干细胞移植 普乐沙福 

分 类 号:R393[医药卫生—基础医学]

 

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