多发性骨髓瘤患者自体造血干细胞动员相关影响因素分析  

Analyze the influencing factors of autologous hematopoietic stem cell mobilization in pa⁃tients with multiple myeloma

作　　者：钱伟[1] 赵一鸣 金凤波[1] QIAN Wei;ZHAO Yiming;JIN Fengbo(The First Affiliated Hospital of Anhui Medical University(North Distric),Anhui Public Health Clinical Center,Hefei,Anhui,China,230000)

机构地区：[1]安徽医科大学第一附属医院(北区)安徽省公共卫生临床中心血液内科

出　　处：《分子诊断与治疗杂志》2024年第8期1506-1510,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省高等学校科学研究项目(2022AH050755)。

摘　　要：目的探讨多发性骨髓瘤患者自体外周血干细胞(APBSC)动员相关的影响因素。方法回顾性分析2019年3月至2023年4月在安徽省公共卫生临床中心收治的38例采用依托泊苷联合G⁃CSF为自体造血干细胞动员方案的多发性骨髓瘤患者的临床资料。包括年龄、性别、体重指数(BMI)、疾病亚型、化疗疗程数、疾病缓解水平、不良反应、CD34+细胞采集数量、动员至采集时间、采集次数、采集前血常规及血脂水平,评估该动员方案的有效性及安全性。根据采集CD34+细胞计数情况,分为优势采集组和非优势采集组,分析上述指标在两组患者中的差异性并探讨影响优势采集的预后因素。结果38例患者总采集成功率为89.47%(34/38),动员至采集中位时间为9(6⁃11)d,采集中位次数为1(1⁃3)次,采集成功者中位CD34+细胞数为5.15(2.32⁃25.5)×10^(6)/kg。6例联合普乐沙福患者采集成功率为100%(6/6),中位CD34+细胞数为7.13(3.08⁃25.5)×10^(6)/kg。不同性别、年龄、BMI水平、原发病缓解水平、化疗疗程数及疾病亚型患者CD34+细胞采集数量间比较差异无统计学意义(P>0.05)。采集前白细胞水平与CD34+细胞数呈显著正相关(P<0.01),多因素回归分析显示,采集前化疗疗程>4程,低LDL⁃C水平是优势采集与否的独立危险因素(P<0.05)。两组患者不良反应发生率间差异无统计学意义(P>0.05)。结论联合普乐沙福的动员方案动员成功率高,不良反应少,是MM患者理想的APBSC动员方案。患者采集前化疗疗程数及LDL⁃C水平是预测优势采集的有效指标。Objective To analyze the influencing factors of autologous hematopoietic stem cell mo⁃bilization in patients with multiple myeloma.Methods A retrospective analysis was conducted on the clinical data of 38 multiple myeloma patients who were admitted to Anhui Public Health Clinical Center between March 2019 and April 2023.These patients underwent autologous hematopoietic stem cell mobilization with etoposide combined with G⁃CSF.The clinical data included age,gender,body mass index(BMI),disease subtype,num⁃ber of chemotherapy cycles,disease remission level,adverse reactions,number of CD34+cells collected,time from mobilization to collection,number of collections,pre⁃collection blood routine and lipid levels.The effi⁃cacy and safety of the mobilization regimen were evaluated.Based on the number of CD34+cells collected,pa⁃tients were divided into two groups:the advantageous collection group and the non⁃advantageous collection group.The differences in the aforementioned indicators between the two groups were analyzed,and prognostic factors affecting advantageous collection were investigated.Results The overall collection success rate for the 38 patients was 89.47%(34/38).The median time from mobilization to collection was 9(6⁃11)days,with a me⁃dian number of collections of 1(1⁃3).The median CD34+cell count among successful collections was 5.15(2.32⁃25.5)×10^(6)/kg.For the 6 patients who received plerixafor,the collection success rate was 100%(6/6),with a median CD34+cell count of 7.13(3.08⁃25.5)×10^(6)/kg.No statistically significant differences were ob⁃served in CD34+cell collection quantities among patients of different genders,ages,BMI levels,primary dis⁃ease remission levels,number of chemotherapy cycles,and disease subtypes(P>0.05).Pre⁃collection white blood cell levels were significantly positively correlated with CD34+cell counts(P<0.01).Multivariate regres⁃sion analysis showed that having more than four chemotherapy cycles before collection and low LDL⁃C levels were independe

关 键 词：外周血造血干细胞 动员 普乐沙福 依托泊苷 低密度脂蛋白 

分 类 号：R733.3[医药卫生—肿瘤]