Stump Sarah E, Trepte Morgan, Shaw J Ryan, Grgic Tatjana, Ptachcinski Jonathan R, Sharf Andrew, Riches Marcie, Shea Thomas C, Park Yara A, Alexander Maurice D
Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Pharmacy, Northside Hospital, Atlanta, GA, USA.
J Oncol Pharm Pract. 2020 Oct;26(7):1590-1597. doi: 10.1177/1078155219900909. Epub 2020 Feb 16.
Plerixafor is a hematopoietic stem cell mobilizing agent used in combination with granulocyte-colony stimulating factor to improve collection for autologous stem cell transplantation. Despite a recommendation for administration 11 h prior to apheresis per package labeling, logistical challenges lead many institutions to administer plerixafor at an extended interval. The purpose of this study was to determine if plerixafor effectively and efficiently mobilizes CD34+ cells when given at an extended interval prior to apheresis. This was a retrospective evaluation of adult patients who received plerixafor based on an algorithm reserving daily plerixafor only for patients with a pre-apheresis CD34+ count of < 20 cells/µL (pre-apheresis plerixafor) or with a low CD34+ yield after the first apheresis session (rescue plerixafor). The primary outcome was achievement of a disease-specific collection goal of ≥ 6 ×10 CD34+ cells/kg for multiple myeloma and ≥ 4 ×10 CD34+ cells/kg for lymphoma. The mean interval between plerixafor administration and apheresis was 17 h in this study. Despite this extended interval, 64% of patients met their disease-specific collection goal. A minimum collection goal of ≥ 2 ×10 CD34+ cells/kg was achieved by 95% of patients. Mobilization remained efficient with a median of two days to complete collection. Based on this data, plerixafor effectively and efficiently mobilizes CD34+ cells when given at an extended interval prior to apheresis.
普乐沙福是一种造血干细胞动员剂，与粒细胞集落刺激因子联合使用，以改善自体干细胞移植的采集效果。尽管包装标签建议在单采前11小时给药，但由于后勤方面的挑战，许多机构在更长的间隔时间给药普乐沙福。本研究的目的是确定在单采前延长间隔时间给药时，普乐沙福是否能有效且高效地动员CD34+细胞。这是一项对成年患者的回顾性评估，这些患者根据一种算法接受普乐沙福治疗，该算法仅将每日普乐沙福用于单采前CD34+计数<20个细胞/微升的患者（单采前普乐沙福）或首次单采后CD34+产量低的患者（挽救性普乐沙福）。主要结局是实现疾病特异性采集目标，即多发性骨髓瘤患者≥6×10⁶个CD34+细胞/千克，淋巴瘤患者≥4×10⁶个CD34+细胞/千克。在本研究中，普乐沙福给药与单采之间的平均间隔时间为17小时。尽管间隔时间延长，但64%的患者达到了疾病特异性采集目标。95%的患者实现了≥2×10⁶个CD34+细胞/千克的最低采集目标。动员仍然有效，中位采集时间为两天。基于这些数据，在单采前延长间隔时间给药时，普乐沙福能有效且高效地动员CD34+细胞。
