Yuan Shan, Wang Shirong, Salhotra Amandeep, Nademanee Auayporn
Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine.
Leuk Lymphoma. 2014 Jul;55(7):1557-62. doi: 10.3109/10428194.2013.847937. Epub 2013 Nov 14.
Hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone/methotrexate, cytarabine (Hyper-CVAD) chemotherapy exerts deleterious effects on peripheral blood stem cell (PBSC) mobilization. We retrospectively reviewed the use of plerixafor to salvage mobilization in 18 Hyper-CVAD treated patients who initially mobilized poorly with chemotherapy and granulocyte colony stimulating factor (G-CSF). After plerixafor administration the median peripheral blood (PB) CD34 + count rose from 3.74/μL (0-17/μL) to 6.85/μL (0-47.2/μL). The patients collected a median of 1.64 (0.21-5.56) × 10(6) CD34 + cells/kg with a median number of 3 (1-4) doses in the same collection cycle, and 11 patients reached the 2.0 × 10(6) CD34 + cells/kg minimum required for transplant. Six patients were remobilized later with G-CSF and plerixafor, and three additional patients reached this goal. For these 14 patients the median number of doses of plerixafor required to reach 2.0 × 10(6) CD34 + cells/kg was 3 (range 1-4). In conclusion, plerixafor can be utilized successfully in many cases to overcome the effects of Hyper-CVAD on PBSC mobilization.
超分割环磷酰胺、长春新碱、阿霉素、地塞米松/甲氨蝶呤、阿糖胞苷（Hyper-CVAD）化疗对外周血干细胞（PBSC）动员产生有害影响。我们回顾性分析了在18例接受Hyper-CVAD治疗的患者中使用普乐沙福挽救动员的情况，这些患者最初化疗联合粒细胞集落刺激因子（G-CSF）动员效果不佳。给予普乐沙福后，外周血（PB）CD34 +细胞计数中位数从3.74/μL（0 - 17/μL）升至6.85/μL（0 - 47.2/μL）。患者在同一采集周期中，中位数采集到1.64（0.21 - 5.56）×10⁶个CD34 +细胞/kg，中位数注射次数为3次（1 - 4次），11例患者达到移植所需的最低2.0×10⁶个CD34 +细胞/kg。6例患者随后使用G-CSF和普乐沙福再次动员，另外3例患者达到此目标。对于这14例患者，达到2.0×10⁶个CD34 +细胞/kg所需的普乐沙福注射次数中位数为3次（范围1 - 4次）。总之，在许多情况下，普乐沙福可成功用于克服Hyper-CVAD对PBSC动员的影响。
