如何管理高剂量化疗和自体干细胞移植中动员效果不佳的患者？
How to manage poor mobilizers for high dose chemotherapy and autologous stem cell transplantation?
作者信息
Ataca Atilla Pinar, Bakanay Ozturk Sule Mine, Demirer Taner
机构信息
Department of Hematology, Ankara University Medical School, Cebeci, 06590 Ankara, Turkey.
Department of Hematology, Ankara Ataturk Hospital, Cankaya, 06800 Ankara, Turkey.
出版信息
Transfus Apher Sci. 2017 Apr;56(2):190-198. doi: 10.1016/j.transci.2016.11.005. Epub 2016 Dec 26.
Today, peripheral blood stem cells are the preferred source of stem cells over bone marrow. Therefore, mobilization plays a crutial role in successful autologous stem cell transplantation. Poor mobilization is generally defined as failure to achieve the target level of at least 2×10 CD34 cells/kg body weight. There are several strategies to overcome poor mobilization: 1) Larger volume Leukapheresis (LVL) 2) Re-mobilization 3) Plerixafor 4) CM+Plerixafor (P)+G-CSF and 5) Bone Marrow Harvest. In this review, the definitions of successful and poor mobilization are discussed. Management strategies for poor mobilization are defined. The recent research on new agents are included.
如今，外周血干细胞是比骨髓更优选的干细胞来源。因此，动员在成功的自体干细胞移植中起着至关重要的作用。动员不佳通常定义为未能达到至少2×10 CD34细胞/千克体重的目标水平。有几种策略可克服动员不佳的情况：1）大容量白细胞分离术（LVL）；2）再次动员；3）普乐沙福；4）环磷酰胺+普乐沙福（P）+粒细胞集落刺激因子（G-CSF）；5）骨髓采集。在本综述中，讨论了成功动员和动员不佳的定义。明确了动员不佳的管理策略。还纳入了关于新药物的最新研究。 （注：原文中“2×10 CD34 cells/kg body weight”表述有误，可能是“2×10⁶ CD34 cells/kg body weight” ）
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