摘要
目的分析普乐沙福(Plerixafor)联合粒细胞集落刺激因子(G-CSF)在淋巴瘤患者中进行自体造血干细胞动员的效果及安全性。方法收集2019年4月至2021年12月在上海交通大学医学院附属瑞金医院采用普乐沙福联合G-CSF(普乐沙福+G-CSF组)或单用G-CSF(G-CSF组)进行自体造血干细胞动员的淋巴瘤患者,回顾性分析两组之间临床资料、干细胞动员/采集成功率、移植后造血重建和治疗不良反应。结果全部184例淋巴瘤患者包括弥漫大B细胞淋巴瘤115例(62.5%)、经典型霍奇金淋巴瘤16例(8.7%)、滤泡性非霍奇金淋巴瘤11例(6.0%)、血管免疫母细胞T细胞淋巴瘤10例(5.4%)、套细胞淋巴瘤6例(3.3%)、间变大细胞淋巴瘤6例(3.3%)、NK/T细胞淋巴瘤6例(3.3%)、伯基特淋巴瘤4例(2.2%)、其他类型B细胞淋巴瘤8例(4.3%)、其他类型T细胞淋巴瘤2例(1.1%)。31例(16.8%)患者曾接受放疗。普乐沙福+G-CSF组84例,G-CSF组100例。普乐沙福+G-CSF组患者年龄较大、复发及三线化疗患者占比较高,其他临床特征基本一致。G-CSF组动员后1 d采集成功率为74.0%,2 d采集成功率为89.0%;普乐沙福+G-CSF组1 d采集成功率为85.7%,2 d采集成功率为97.6%。普乐沙福+G-CSF组的动员成功率明显高于单用G-CSF组(P=0.023)。普乐沙福+G-CSF组、G-CSF组采集CD34^(+)细胞中位数分别为3.9(0.7~21.2)×10^(6)/kg、3.2(0.6~19.4)×10^(6)/kg(P=0.001)。普乐沙福+G-CSF组常见的不良反应为1~2级胃肠道反应(31.2%)、局部皮肤发红(2.4%)。结论普乐沙福联合G-CSF用于淋巴瘤患者自体造血干细胞动员/采集成功率、CD34^(+)细胞采集量均明显高于单用G-CSF,不良反应少,即使在年龄较大、二线动员、复发或者多次化疗的患者中也具有较高的动员成功率。
Objective To evaluate the advantages and safety of Plerixafor in combination with granulocyte colony-stimulating factor(G-CSF)in autologous hematopoietic stem cell mobilization of lymphoma.Methods Lymphoma patients who received autologous hematopoietic stem cell mobilization with Plerixafor in combination with G-CSF or G-CSF alone were obtained.The clinical data,the success rate of stem cell collection,hematopoietic reconstitution,and treatment-related adverse reactions between the two groups were evaluated retrospectively.Results A total of 184 lymphoma patients were included in this analysis,including 115 cases of diffuse large B-cell lymphoma(62.5%),16 cases of classical Hodgkin's lymphoma(8.7%),11 cases of follicular non-Hodgkin's lymphoma(6.0%),10 cases of angioimmunoblastic T-cell lymphoma(5.4%),6 cases of mantle cell lymphoma(3.3%),and 6 cases of anaplastic large cell lymphoma(3.3%),6 cases of NK/T-cell lymphoma(3.3%),4 cases of Burkitt's lymphoma(2.2%),8 cases of other types of B-cell lymphoma(4.3%),and 2 cases of other types of T-cell lymphoma(1.1%);31 patients had received radiotherapy(16.8%).The patients in the two groups were recruited with Plerixafor in combination with G-CSF or G-CSF alone.The baseline clinical characteristics of the two groups were basically similar.The patients in the Plerixafor in combination with the G-CSF mobilization group were older,and the number of recurrences and third-line chemotherapy was higher.100 patients were mobilized with G-CSF alone.The success rate of the collection was 74.0% for one day and 89.0% for two days.84 patients in the group of Plerixafor combined with G-CSF were recruited successfully with 85.7% for one day and 97.6% for two days.The success rate of mobilization in the group of Plerixafor combined with G-CSF was substantially higher than that in the group of G-CSF alone(P=0.023).The median number of CD34^(+)cells obtained in the mobilization group of Plerixafor combined with G-CSF was 3.9×10^(6)/kg.The median number of CD34^(+)cells obtained in the G-CSF Mobilization group alone was 3.2×10^(6)/kg.The number of CD34^(+)cells collected by Plerixafor combined with G-CSF was considerably higher than that in G-CSF alone(P=0.001).The prevalent adverse reactions in the group of Plerixafor combined with G-CSF were grade 1-2 gastrointestinal reactions(31.2%)and local skin redness(2.4%).Conclusion The success rate of autologous hematopoietic stem cell mobilization in lymphoma patients treated with Plerixafor combined with G-CSF is significantly high.The success rate of collection and the absolute count of CD34^(+)stem cells were substantially higher than those in the group treated with G-CSF alone.Even in older patients,second-line collection,recurrence,or multiple chemotherapies,the combined mobilization method also has a high success rate of mobilization.
作者
纪濛濛
沈一格
龚吉昌
唐暐
许晓倩
郑重
陈思远
赫洋
郑欣
赵林娣
赵维莅
吴文
Ji Mengmeng;Shen Yige;Gong Jichang;Tang Wei;Xu Xiaoqian;Zheng Zhong;Chen Siyuan;He Yang;Zheng Xin;Zhao Lindi;Zhao Weili;Wu Wen(Shanghai Institute of Hematology,State Key Laboratory of Medical Genomics,National Research Center for Translational Medicine at Shanghai,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2023年第2期112-117,共6页
Chinese Journal of Hematology
基金
国家自然科学基金重点项目(82130004)
申康重大临床研究项目(SHDC2020CR1032B)。
关键词
普乐沙福
粒细胞集落刺激因子
淋巴瘤
自体造血干细胞动员
Plerixafor
Granulocyte colony stimulating factor
Lymphoma
Autologous hematopoietic stem cell mobilization
