Department of Clinical Immunology, Blood Bank, Copenhagen University Hospital, Copenhagen, Denmark.
Transfusion. 2014 Apr;54(4):1055-8. doi: 10.1111/trf.12383. Epub 2013 Aug 14.
In allogeneic hematopoietic stem cell (HSC) transplantation, collection of a sufficient number of HSCs at a fixed time point is crucial. For HSC mobilization into the peripheral blood, the standard regimen, that is, granulocyte-colony-stimulating factor (G-CSF), may be inadequate. Use of plerixafor as adjuvant to G-CSF is so far off-label in healthy donors.
We present six cases in which the "just-in-time" addition of plerixafor ensured proper CD34+ collection from healthy donors with insufficient G-CSF mobilization. In four of these cases a high number of CD34+ cells was needed due to subsequent CD34+ selection or haploidentical transplantation.
From all six donors a sufficient number of CD34+ cells was obtained by using plerixafor as an adjuvant to G-CSF. This treatment regimen resulted in only mild side effects for the donor.
We have presented six cases with different causes leading to insufficient G-CSF mobilization in allogeneic donors and in which the administration of plerixafor just-in-time ensured a proper graft for transplantation.
在异基因造血干细胞(HSC)移植中,在固定时间点采集足够数量的 HSC 至关重要。对于 HSC 动员到外周血中,标准方案即粒细胞集落刺激因子(G-CSF)可能不够。迄今为止,在健康供体中,使用培洛昔福作为 G-CSF 的辅助剂是超适应证的。
我们报告了 6 例病例,其中“及时”添加培洛昔福确保了在 G-CSF 动员不足的健康供体中适当采集 CD34+细胞。在其中 4 例病例中,由于随后进行 CD34+选择或半相合移植,需要大量的 CD34+细胞。
从所有 6 名供体中,通过使用培洛昔福作为 G-CSF 的辅助剂,获得了足够数量的 CD34+细胞。这种治疗方案仅对供体产生轻微的副作用。
我们报告了 6 例不同原因导致异基因供体中 G-CSF 动员不足的病例,及时给予培洛昔福的治疗确保了适当的移植物用于移植。