Baertsch Marc-Andrea, Kriegsmann Katharina, Pavel Petra, Bruckner Thomas, Hundemer Michael, Kriegsmann Mark, Ho Anthony D, Goldschmidt Hartmut, Wuchter Patrick
Department of Medicine V (Hematology, Oncology and Rheumatology), University Hospital Heidelberg, Heidelberg, Germany.
Stem Cell Laboratory, IKTZ Heidelberg GmbH, Heidelberg, Germany.
Transfus Med Hemother. 2018 Jan;45(1):24-31. doi: 10.1159/000478911. Epub 2017 Oct 4.
A low platelet count before mobilization has recurrently been identified as risk factor for poor mobilization.
To determine the relevance of this finding for peripheral blood stem cell (PBSC) mobilization, including pre-emptive or rescue plerixafor in the case of poor mobilization, we retrospectively analyzed all patients undergoing PBSC collection at our institution between January 2014 and December 2015 (n = 380).
In total, 99% of the patients (377/380) successfully collected a minimum of 2 × 10 CD34+ cells/kg body weight sufficient for a single transplant. Rescue or pre-emptive plerixafor was administered to 11% of the patients (42/380). No correlations between the platelet count before mobilization and the number of peripheral blood CD34+ cells or the CD34+ cell collection result were detected in the entire population or the subgroups according to diagnosis (newly diagnosed multiple myeloma, relapsed multiple myeloma, lymphoma, amyloid light-chain amyloidosis, sarcoma, or germ cell tumor). However, patients requiring pre-emptive or rescue plerixafor had a significantly lower platelet count before mobilization (217/nl vs. 245/nl; p = 0.004).
With the current state of the art PBSC mobilization strategies, the platelet count before mobilization was not associated with the CD34+ cell collection result but was associated with the need for pre-emptive or rescue application of plerixafor.
动员前血小板计数低反复被确定为动员效果不佳的危险因素。
为确定这一发现对外周血干细胞(PBSC)动员的相关性,包括在动员效果不佳时进行抢先或挽救性使用普乐沙福,我们回顾性分析了2014年1月至2015年12月在我们机构接受PBSC采集的所有患者(n = 380)。
总共99%的患者(377/380)成功采集到至少2×10个CD34+细胞/kg体重,足以进行单次移植。11%的患者(42/380)接受了挽救或抢先使用普乐沙福。在整个人群或根据诊断划分的亚组(新诊断的多发性骨髓瘤、复发的多发性骨髓瘤、淋巴瘤、淀粉样轻链淀粉样变性、肉瘤或生殖细胞肿瘤)中,未检测到动员前血小板计数与外周血CD34+细胞数量或CD34+细胞采集结果之间存在相关性。然而,需要抢先或挽救性使用普乐沙福的患者动员前血小板计数显著更低(217/μl对245/μl;p = 0.004)。
采用当前先进的PBSC动员策略,动员前血小板计数与CD34+细胞采集结果无关,但与抢先或挽救性使用普乐沙福的需求有关。