Ria Roberto, Reale Antonia, Melaccio Assunta, Racanelli Vito, Dammacco Franco, Vacca Angelo
Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari Medical School, Bari, Italy,
Clin Exp Med. 2015 May;15(2):145-50. doi: 10.1007/s10238-014-0282-9. Epub 2014 Apr 11.
Patients with lymphoproliferative disorders, candidate to autologous stem cell transplantation (ASCT), require mobilization with chemotherapy and granulocyte colony -stimulating factor (G-CSF). This study looked for differences in hematopoietic peripheral stem cells (HPSCs) mobilization in response to the three available G-CSFs, namely lenograstim, filgrastim, and pegfilgrastim. Between 2000 and 2012, 146 patients (66 M and 80 F) who underwent ASCT for multiple myeloma, non-Hodgkin's lymphoma or Hodgkin's lymphoma were studied. All patients received induction therapy and then a mobilization regimen with cyclophosphamide plus lenograstim, or filgrastim, or pegfilgrastim. From days 12 to 14, HPSCs were collected by two to three daily leukaphereses. Our results show that high-dose cyclophosphamide plus lenograstim achieved adequate mobilization and the collection target more quickly and with fewer leukaphereses as compared to filgrastim and pegfilgrastim. No differences between the three regimens were observed regarding toxicity and days to WBC and platelet recovery. Thus, lenograstim may represent the ideal G-CSF for PBSC mobilization in patients with lymphoproliferative diseases. Further studies are needed to confirm these results and better understand the biological bases of these differences.
适合自体干细胞移植（ASCT）的淋巴增殖性疾病患者需要通过化疗和粒细胞集落刺激因子（G-CSF）进行动员。本研究探寻了三种可用的G-CSF，即来格司亭、非格司亭和培非格司亭在动员造血外周干细胞（HPSC）方面的差异。在2000年至2012年期间，对146例因多发性骨髓瘤、非霍奇金淋巴瘤或霍奇金淋巴瘤接受ASCT的患者（66例男性和80例女性）进行了研究。所有患者均接受诱导治疗，然后采用环磷酰胺加利妥昔单抗，或非格司亭，或培非格司亭进行动员方案。从第12天到第14天，通过每天进行两到三次白细胞分离术采集HPSC。我们的结果表明，与非格司亭和培非格司亭相比，高剂量环磷酰胺加利妥昔单抗能更快地实现充分动员并达到采集目标，且白细胞分离术次数更少。在毒性以及白细胞和血小板恢复天数方面，三种方案之间未观察到差异。因此，来格司亭可能是淋巴增殖性疾病患者PBSC动员的理想G-CSF。需要进一步研究来证实这些结果，并更好地理解这些差异的生物学基础。
