背景:已证明粒细胞集落刺激因子(G-CSF)加plerixafor可提高外周血干细胞(PBSC)动员的功效,然而,由于它的高价格,plerixafor的使用在中国是有限的。这项研究的目的是评估残留的plerixafor对多发性骨髓瘤(MM)患者第二天干细胞动员的疗效。
方法:在这项单中心回顾性研究中,69例MM患者接受G-CSF+plerixafor动员PBSCs,从28名患者中收集的仅一天和41名患者中收集的两天。一些患者接受了残余的plerixafor,第二天收集PBSC。关于特征的数据,收集并分析不同剂量的plerixafor和PBSC动员的疗效。
结果:经过1或2次单采手术,85.5%的患者收集超过2×106个细胞/kg的PBSCs。第1天用不同剂量的plerixafor进行CD34+PBSC动员成功率差异无统计学意义,但残余plerixafor剂量较高导致第二天的成功率较高(P<0.001)。在收集PBSCs两天的患者中,24例患者(58.5%)的CD34+细胞产量水平变化较好,与第2天的残余plerixafor剂量显着相关(P=0.001)。
结论:这些结果表明,在第二天施用残留的plerixafor以动员干细胞是经济的,有效和临床可行的方法。
BACKGROUND: Granulocyte colony-stimulating factor (G-CSF) plus plerixafor has been shown to improve the efficacy of peripheral blood stem cell (PBSC) mobilization, however, due to its high price, the use of plerixafor is limited in
China. The purpose of this study was to assess the efficacy of residual plerixafor for second-day stem cell mobilization in multiple myeloma (MM) patients.
METHODS: In this single-center retrospective study, 69 MM patients received G-CSF + plerixafor to mobilize PBSCs, which were collected from 28 patients only for one day and 41 patients for two days. Some of the patients received residual plerixafor, and PBSCs were collected on the second day. The data on the characteristics, different doses of plerixafor and efficacy of PBSC mobilization were collected and analyzed.
RESULTS: After 1 or 2 apheresis procedures, 85.5% of patients collected more than 2 × 106 cells/kg PBSCs. There was no statistically significant difference in the success rate of CD34 + PBSC mobilization with the different doses of plerixafor on the first day, but the higher residual plerixafor dose resulted in better success rates on the second day (P<0.001). Among the patients who collected PBSCs for two days, the level of the CD34 + cell yield of 24 patients (58.5%) changed better, which was significantly correlated with the dose of residual plerixafor on the second day (P = 0.001).
CONCLUSIONS: These results suggested that the administration of residual plerixafor to mobilize stem cells on the second day is an economical, efficient and clinically feasible method.