Zappasodi Patrizia, Nosari Anna Maria, Astori Cesare, Ciapanna Dennis, Bonfichi Maurizio, Varettoni Marzia, Mangiacavalli Silvia, Morra Enrica, Lazzarino Mario, Corso Alessandro
Division of Hematology, Foundation IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
Transfusion. 2008 May;48(5):857-60. doi: 10.1111/j.1537-2995.2007.01621.x. Epub 2008 Feb 1.
Pegylated filgrastim (PEG-f), a long-lasting granulocyte-colony-stimulating factor, has been used in different hematologic conditions to shorten chemotherapy-induced neutropenia and to mobilize peripheral blood stem cells. Data on mobilization efficacy in patients with multiple myeloma are, however, still limited.
The feasibility and mobilizing capacity of DCEP chemotherapy followed by a single subcutaneous dose of 6 mg of PEG-f in 23 myeloma patients (11 females and 12 males) whose median age was 55 years (range, 31-67 years) were investigated.
The median number of CD34+ cells collected was 5.72 x 10(6) per kg body weight with a range between 0 x 10(6) and 29.4 x 10(6) per kg body weight. Twenty patients (87%) yielded more than 2 x 10(6) per kg body weight CD34+ cells. Among the 22 patients who mobilized some CD34+ cells, 27 leukapheresis procedures were carried out (a single leukapheresis procedure in 17 patients and 2 leukapheresis procedures in 5). The median interval between the start of chemotherapy and the first leukapheresis procedure was 12 days (range, 11-16 days). With regard to tolerability, 7 patients complained of mild to moderate back pain, controlled with oral analgesics. No patient was hospitalized, and no fever or infections occurred.
These results, compared with those previously reported for the DCEP-filgrastim combination, suggest that DCEP chemotherapy followed by PEG-f is a promising combination to mobilize peripheral blood stem cells in myeloma patients.
聚乙二醇化非格司亭（PEG - f）是一种长效粒细胞集落刺激因子，已用于不同血液学疾病，以缩短化疗引起的中性粒细胞减少症并动员外周血干细胞。然而，关于多发性骨髓瘤患者动员效果的数据仍然有限。
对23例骨髓瘤患者（11例女性和12例男性）进行了研究，这些患者的中位年龄为55岁（范围31 - 67岁），采用DCEP化疗后皮下注射单次剂量6 mg的PEG - f，研究其可行性和动员能力。
每千克体重收集的CD34 +细胞中位数为5.72×10⁶，范围为每千克体重0×10⁶至29.4×10⁶。20例患者（87%）每千克体重产生的CD34 +细胞超过2×10⁶。在22例动员出一些CD34 +细胞的患者中，进行了27次白细胞分离术（17例患者进行单次白细胞分离术，5例患者进行2次白细胞分离术）。化疗开始至首次白细胞分离术的中位间隔时间为12天（范围11 - 16天）。关于耐受性，7例患者抱怨有轻度至中度背痛，口服镇痛药可控制。无患者住院，未发生发热或感染。
与先前报道的DCEP - 非格司亭联合方案的结果相比，这些结果表明DCEP化疗后使用PEG - f是一种有前景的用于动员骨髓瘤患者外周血干细胞的联合方案。
