Magagnoli M, Spina M, Balzarotti M, Timofeeva I, Isa L, Michieli M, Capizzuto R, Morenghi E, Castagna L, Tirelli U, Santoro A
Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, Italy.
Bone Marrow Transplant. 2007 Dec;40(11):1019-25. doi: 10.1038/sj.bmt.1705862. Epub 2007 Oct 1.
We explored the efficacy of the IGEV regimen (ifosfamide, gemcitabine, vinorelbine and prednisone) combined with a fixed dose of lenograstim (263 mug/day) to mobilize peripheral blood stem cells (PBSCs) in 90 Hodgkin's lymphoma patients. The median total CD34+ cells/mul peak, colony-forming units granulocyte-macrophage and white blood cells for all individual collection sets were 85/mul, 12 x 10(4)/kg and 20 700/mul, respectively. An adequate number of CD34+ cells (more than 3 x 10(6) or 6 x 10(6) CD34+ cells/kg depending on whether single or tandem high-dose chemotherapy was used) were collected in 89 out of 90 (98.7%) mobilized patients, whereas the only failure reached 2.3 x 10(6) CD34+ cells/kg. The median CD34+ cell collections were 11 x 10(6)/kg (range 2.3-39 x 10(6)/kg) and 10 x 10(6)/kg (range 6-22.0 x 10(6)/kg) with a median of 1 and 2 leukaphereses for patients eligible for single high-dose treatment and for candidates for tandem transplant, respectively. Target yields were reached in 71.43 and 49.09% and additionally in 17.14 and 43.64% of cases after the first and second apheresis procedures, respectively. Hematological and non-hematological side effects were acceptable, and no toxic deaths occurred. Thirty-four patients received a single and 47 received tandem transplantation with rapid engraftment. These results confirm that the IGEV regimen with lenograstim support can be used successfully and safely to mobilize PBSCs.
我们探讨了IGEV方案（异环磷酰胺、吉西他滨、长春瑞滨和泼尼松）联合固定剂量的来格司亭（263μg/天）用于动员90例霍奇金淋巴瘤患者外周血干细胞（PBSC）的疗效。所有单个采集样本中，CD34⁺细胞/μl峰值、粒-巨噬细胞集落形成单位和白细胞的中位数分别为85/μl、12×10⁴/kg和20700/μl。90例动员患者中有89例（98.7%）采集到了足够数量的CD34⁺细胞（根据使用的是单次还是串联高剂量化疗，分别为超过3×10⁶或6×10⁶个CD34⁺细胞/kg），而唯一未达标的患者采集量为2.3×10⁶个CD34⁺细胞/kg。对于符合单次高剂量治疗的患者和串联移植候选者，CD34⁺细胞采集量的中位数分别为11×10⁶/kg（范围2.3 - 39×10⁶/kg）和10×10⁶/kg（范围6 - 22.0×10⁶/kg），白细胞分离术的中位数分别为1次和2次。在首次和第二次采集程序后，分别有71.43%和49.09%的病例达到了目标产量，另外在首次和第二次采集程序后分别还有17.14%和43.64%的病例达到目标产量。血液学和非血液学副作用均可接受，且未发生毒性死亡。34例患者接受了单次移植，47例患者接受了串联移植，移植后造血迅速恢复。这些结果证实，IGEV方案联合来格司亭支持能够成功且安全地用于动员外周血干细胞。
