Matsue Kosei, Kumagai Kyoya, Sugiura Isamu, Ishikawa Takayuki, Igarashi Tadahiko, Sato Tsutomu, Uchiyama Michihiro, Miyamoto Toshihiro, Ono Takaaki, Ueda Yasunori, Kiguchi Toru, Sunaga Yoshinori, Sasaki Toru, Suzuki Kenshi
Department of Hematology and Oncology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.
Division of Hematology and Oncology, Chiba Cancer Center, Chiba, Japan.
Int J Hematol. 2018 Nov;108(5):524-534. doi: 10.1007/s12185-018-2505-4. Epub 2018 Jul 24.
The present study (ClinicalTrials.gov Identifier: NCT02221492) was conducted to assess the efficacy and safety of plerixafor for the mobilization and collection of haematopoietic stem cells (HSCs) for autologous transplantation in Japanese non-Hodgkin lymphoma (NHL) patients. In this randomized phase 2 study, patients received granulocyte-colony stimulating factor (G-CSF, filgrastim) 400 µg/m²/day for up to 8 days. Starting on the evening of day 4, patients received, for up to 4 days, either plerixafor (240 µg/kg/day) in the G-CSF+ plerixafor arm (GP arm) or G-CSF alone arm (G arm). On day 5, daily apheresis started and was continued for up to 4 days, or until ≥ 5 × 10 CD34+ cells/kg was collected. A total of 32 patients were randomized to either the GP or G arm. In the GP arm, 9/16 patients (56.3%) achieved collection of ≥ 5 × 10 CD34+ cells/kg in ≤ 4 days of apheresis, while 1/16 patient (6.3%) achieved this target in the G arm. The most common treatment-emergent adverse events in the GP arm were back pain (56.3%), platelet count decreased (25.0%), headache, diarrhoea, and nausea (18.8% each). We found that plerixafor was well tolerated and effective for the mobilization and collection of peripheral HSCs for autologous transplantation in Japanese NHL patients.
本研究(ClinicalTrials.gov标识符:NCT02221492)旨在评估普乐沙福用于动员和采集造血干细胞(HSC)以进行日本非霍奇金淋巴瘤(NHL)患者自体移植的疗效和安全性。在这项随机2期研究中,患者接受粒细胞集落刺激因子(G-CSF,非格司亭)400μg/m²/天,持续至多8天。从第4天晚上开始,在G-CSF加普乐沙福组(GP组)的患者接受普乐沙福(240μg/kg/天),持续至多4天,而在G-CSF单药组(G组)患者仅接受G-CSF。在第5天开始每日进行单采,持续至多4天,或直至采集到≥5×10⁶个CD34⁺细胞/kg。共有32例患者被随机分配至GP组或G组。在GP组中,9/16例患者(56.3%)在单采≤4天内实现采集到≥5×10⁶个CD34⁺细胞/kg,而在G组中1/16例患者(6.3%)达到该目标。GP组中最常见的治疗中出现的不良事件为背痛(56.3%)、血小板计数降低(25.0%)、头痛、腹泻和恶心(各18.8%)。我们发现普乐沙福耐受性良好,对于日本NHL患者动员和采集外周HSC进行自体移植有效。