Department of Haematology, Saint-Antoine Hospital, Paris, France.
Department of Haematology, Pitie-Salpetriere Hospital, Paris, France.
Bone Marrow Transplant. 2018 Mar;53(3):246-254. doi: 10.1038/s41409-017-0033-0. Epub 2017 Dec 18.
High-dose chemotherapy alongside peripheral blood stem cell (PBSC) infusion has become the standard of care in different hematologic malignancies. The goal of PBSC mobilization is to allow collection of sufficient CD34+ cells to proceed to transplantation. The current mobilization regimen with granulocyte colony-stimulating factor (G-CSF), alone or in combination with chemotherapy, still fails in 10-25% of patients. Plerixafor is able to rescue most of these patients from mobilization failure. In this study, we investigated the impact of plerixafor on the cost and time spent on apheresis in patients who were considered poor mobilizers, with <20 × 10/µl peripheral CD34+ cells after mobilization but prior to apheresis. Patient hospital records from ten centers in three European countries were reviewed and compared during two time periods, namely prior and after plerixafor introduction to the market. During the plerixafor period, patients spent less time on apheresis (350 vs. 461 min). Poor mobilizers given plerixafor collected more CD34+ cells during the first apheresis session, leading to a decrease in the average number of apheresis sessions needed. The total apheresis yield was unaffected. This analysis shows that the use of plerixafor lessens the time-effort associated with the management of poor mobilizers and reduces apheresis costs.
大剂量化疗联合外周血造血干细胞（PBSC）输注已成为不同血液系统恶性肿瘤的标准治疗方法。PBSC 动员的目的是采集足够数量的 CD34+细胞以进行移植。目前，使用粒细胞集落刺激因子（G-CSF）单独或联合化疗的动员方案仍有 10-25%的患者失败。plerixafor 能够使大多数这些动员失败的患者得到挽救。在这项研究中，我们研究了 plerixafor 对动员后外周血 CD34+细胞<20×10/µl 但在采集前被认为是动员不良的患者的采集成本和采集时间的影响。对来自三个欧洲国家的十个中心的患者的医院记录进行了回顾和比较，分为 plerixafor 上市前后两个时期。在 plerixafor 时期，患者的采集时间更短（350 分钟与 461 分钟）。接受 plerixafor 治疗的动员不良患者在第一次采集时收集了更多的 CD34+细胞，这导致所需的采集次数减少。总采集产量不受影响。这项分析表明，plerixafor 的使用减轻了管理动员不良患者相关的时间和精力，降低了采集成本。
