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低剂量环磷酰胺和粒细胞集落刺激因子足以动员多发性骨髓瘤患者的外周血造血干细胞。

Low-dose cyclophosphamide and granulocyte colony-stimulating factor are sufficient for peripheral blood stem cell mobilization in patients with multiple myeloma.

机构信息

Department of Hematology, Erciyes University, Kayseri, Turkey.

Department of Bone Marrow Transplantation, Erciyes University, Kayseri, Turkey.

出版信息

Transfus Apher Sci. 2020 Oct;59(5):102844. doi: 10.1016/j.transci.2020.102844. Epub 2020 Jun 6.

Abstract

Autologous stem cell transplantation (ASCT), supported by high-dose chemotherapy, is the prevalent option for multiple myeloma (MM) treatment in candidates suitable for transplantation. Although granulocyte colony-stimulating factor (G-CSF) supported cyclophosphamide (CY) is used as the pre-ASCT mobilization regimen, there is no consensus on the optimal dosage of CY. Thus, in this study, we examined the results of 47 MM patients, who underwent ASCT after mobilization with intermediate (ID) or low-dose (LD) CY treatment supported with G-CSF. As the mobilization regimen, we used ID (2.4 g/m) of CY in 22 patients, and LD (1 g/m) of CY in 25 patients. Adequate doses of CD34+ cells were collected in both groups. At the same time, febrile neutropenia was observed to be less common in patients in the LD-CY group. Additionaly 96% of patients in LD-CY group did not need to be hospitalized during the mobilization. In conclusion, we think that mobilization with LD-CY and G-CSF is advantageous since it results in a sufficient amount of stem cells in addition to being advantageous in terms of patient safety and cost.

摘要

自体干细胞移植(ASCT),在适合移植的患者中,支持高强度化疗,是多发性骨髓瘤(MM)治疗的主流选择。虽然粒细胞集落刺激因子(G-CSF)支持环磷酰胺(CY)被用作 ASCT 前动员方案,但 CY 的最佳剂量尚无共识。因此,在这项研究中,我们检查了 47 名 MM 患者的结果,他们在接受 G-CSF 支持的中等剂量(ID)或低剂量(LD)CY 治疗动员后接受了 ASCT。作为动员方案,我们在 22 名患者中使用 ID(2.4g/m)的 CY,在 25 名患者中使用 LD(1g/m)的 CY。两组均采集到足够数量的 CD34+细胞。同时,在 LD-CY 组中观察到发热性中性粒细胞减少症较少见。此外,LD-CY 组 96%的患者在动员期间无需住院。总之,我们认为 LD-CY 和 G-CSF 动员具有优势,因为它不仅有利于患者安全和成本,而且还能产生足够数量的干细胞。

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