背景:在淋巴瘤的自体造血干细胞移植(auto-HSCT)中,联合化疗和非格司亭(rhG-CSF)的动员策略的高动员失败率是尚未解决的问题之一。是否组合聚乙二醇非格司亭[pegfilgrastim(PEG-FIL),PEG-rhG-CSF]和非格司亭(FIL)可提高动员成功率,并且尚未研究联合治疗的时机。
方法:回顾性纳入107例接受自体HSCT的淋巴瘤患者,并分为PEG+FIL和FIL组。PEG+FIL组在化疗的第三天接受pegfilgrastim(9mg),然后是基于外周血干细胞(PBSC)计数的非格司亭(10μg/kg/天)。根据PBSC的数量,FIL组接受非格司亭10μg/kg/天。
结果:PEG+FIL组的中性粒细胞减少性发热发生率明显低于FIL组。PEG+FIL组自体干细胞移植白细胞平均恢复时间明显短于FIL组。与FIL组相比,PEG+FIL组的住院费用较低.我们发现,联合治疗更适合骨髓造血面积小于30%的患者。Filgrastim最好在pegfilgrastim给药后5-6天给药。
结论:与常规非格司亭动员相比,pegfilgrastim和filgrastim的组合具有很高的疗效,非劣质安全性,和优越的健康经济效益在自动HSCT。
BACKGROUND: The high mobilization failure rate with the mobilization strategy of combining chemotherapy and filgrastim (rhG-CSF) in autologous hematopoietic stem cell transplantation (auto-HSCT) in lymphomas is one of the unresolved issues. Whether the combination of polyethylene glycol filgrastim [pegfilgrastim (PEG-FIL), PEG-rhG-CSF] and filgrastim (FIL) improves the mobilization success rate and the timing of combination therapy has not been studied.
METHODS: 107 lymphoma patients who received auto-HSCT were retrospectively enrolled and divided into groups of PEG+FIL and FIL. The group of PEG+FIL received pegfilgrastim (9 mg) on the third day of the chemotherapy, followed by filgrastim (10 μg/kg/day) based on the counts of peripheral blood stem cells (PBSC). The group of FIL received filgrastim 10 μg /kg/day depending on the number of PBSCs.
RESULTS: The incidence of neutropenic fever in the group of PEG+FIL was significantly lower than in the group of FIL. The mean recovery time of leukocytes at autologous stem cell transplantation was significantly shorter in the group of PEG+FIL than in the group of FIL. Compared to the groups of FIL, the group of PEG+FIL had lower hospitalization costs. We found that the combination therapy is more recommended for patients with a bone marrow hematopoietic area of less than 30 %. Filgrastim is best administered 5-6 days after pegfilgrastim administration.
CONCLUSIONS: Compared to conventional filgrastim mobilization, the combination of pegfilgrastim and filgrastim schedule has high efficacy, non-inferior safety, and superior health economic benefits during auto-HSCT.