Tricot Guido, Barlogie Bart, Zangari Maurizio, van Rhee Frits, Hoering Antje, Szymonifka Jackie, Cottler-Fox Michele
University of Utah School of Medicine, 30N 1900E, 5C402,Salt Lake City, UT 84132 USA.
Haematologica. 2008 Nov;93(11):1739-42. doi: 10.3324/haematol.13204. Epub 2008 Aug 25.
Quality and quantity of mobilized peripheral blood stem cells determine the safety of tandem autologous transplants in myeloma. Using the same mobilization chemotherapy with DT-PACE in two consecutive protocols, robustness of stem cell collection and rapidity of engraftment after transplantation were assessed. We employed either twice a day filgrastim versus two doses of pegfilgrastim. Advantages of pegfilgrastim were: (i) a higher percentage of patients collected 15x10(6)/kg in the first three days (p<0.001); (ii) the median number of CD34 cells/kg collected on day 1 was higher (p=0.004); (iii) the median number of growth factor injections was 2 versus 26 (p<0.0001); (iv) post-transplantation neutrophil recovery was faster after first and second transplant (p<0.001) and (v) platelet recovery was faster after first transplant (when less stem cells were infused) (p=0.01). Pegfilgrastim may be considered the standard of care for stem cell mobilization.
动员外周血干细胞的质量和数量决定了骨髓瘤串联自体移植的安全性。在两个连续的方案中使用相同的含DT - PACE的动员化疗，评估干细胞采集的稳健性和移植后植入的快速性。我们采用每日两次使用非格司亭与两剂培非格司亭进行对比。培非格司亭的优势在于：（i）在前三天收集到15×10⁶/kg的患者百分比更高（p<0.001）；（ii）第1天收集的CD34细胞/kg中位数更高（p = 0.004）；（iii）生长因子注射的中位数为2次对比26次（p<0.0001）；（iv）第一次和第二次移植后移植后中性粒细胞恢复更快（p<0.001）以及（v）第一次移植后（输注的干细胞较少时）血小板恢复更快（p = 0.01）。培非格司亭可被视为干细胞动员的标准治疗方法。
