Greil Christine, Kiote-Schmidt Chrissoula, Fink Geertje, Ihorst Gabriele, Hildenbeutel Steffi, Bosse Roland, Duyster Justus, Engelhardt Monika, Wäsch Ralph
a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
b Clinical Trials Unit , Faculty of Medicine, University of Freiburg , Freiburg , Germany.
Leuk Lymphoma. 2017 Aug;58(8):1849-1858. doi: 10.1080/10428194.2016.1271946. Epub 2017 Jan 13.
Plerixafor, although costly, is added to mobilizing chemotherapy and G-CSF to overcome poor stem cell mobilization. We demonstrate that it can be safely administered mostly once as a single dose in preemptive and rescue settings, leading to apheresis yields of >2 and >4×10 CD34 + cells/kg body weight (bw) in 83% and 48%, respectively. Of note, 35/46 (76%) patients showed a substantial benefit with increased peripheral blood (PB) CD34 + cells prior to apheresis (8.84 vs. 1.72/μl, p < .001), and 5-fold increased CD34 + cells collected per single apheresis (2.25 vs. 0.43 × 10 CD34+/kg bw, respectively, p < .001). Patients profiting most (76%) vs. less (24%) had >5 vs. <5/μl PB CD34 + cells before plerixafor application, respectively, thus careful patient selection in the latter group is advised. To the best of our knowledge, this is the first report demonstrating that favorable apheresis results can be obtained using this cost-efficient, single fixed-dose plerixafor schedule.
普乐沙福虽然成本高昂，但可添加到动员化疗和粒细胞集落刺激因子中，以克服干细胞动员不佳的问题。我们证明，在抢先治疗和挽救治疗中，它大多可以安全地单次给药，分别使83%和48%的患者单采产量达到>2×10⁶和>4×10⁶个CD34⁺细胞/千克体重。值得注意的是，46例患者中有35例（76%）在单采前外周血（PB）CD34⁺细胞增加方面有显著获益（8.84对1.72/μl，p<0.001），且每次单采收集的CD34⁺细胞增加了5倍（分别为2.25对0.43×10⁶个CD34⁺/千克体重，p<0.001）。获益最多的患者（76%）与获益较少的患者（24%）在应用普乐沙福前PB CD34⁺细胞分别>5和<5/μl，因此建议对后一组患者进行仔细的选择。据我们所知，这是第一份报告表明使用这种具有成本效益的单一固定剂量普乐沙福方案可获得良好的单采结果。
