Li Jiali, Wang Sanbin, Zhang Yicheng, Lou Shifeng, Liu Yao, Kong Peiyan, Zhang Cheng, Gao Lei, Peng Xiangui, Wang Ping, Deng Xiaojuan, Gao Li, Zhang Xi
Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, China.
State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, Chongqing, China.
Front Oncol. 2020 Sep 3;10:1598. doi: 10.3389/fonc.2020.01598. eCollection 2020.
The mobilization of hematopoietic stem cells (HSCs) using granulocyte colony-stimulating factor is a classic method. Recently, a single injection of pegfilgrastim was used to mobilize CD34+ cells in some small-sample studies. To confirm the efficacy and safety of pegfilgrastim in the mobilization of CD34+ cells from healthy donors, we conducted a retrospective multicenter study. A total of 146 healthy donors who all received subcutaneous pegfilgrastim (12 mg) on day 1 were enrolled in our study. Donor HSC apheresis was conducted on day 5. The primary endpoint was the percentage of donors from whom ≥4 × 10 CD34+ cells/kg were collected in a single apheresis session. The median number of CD34+ cells in donors was significantly higher on day 5 than that on day 4 (82.26 μL vs. 51.65 μL, ¡ 0.001). In 111 of the 146 donors, an optimal number of CD34+ cells (≥4 × 10 kg) were collected in a single apheresis procedure. Bone pain and headache were the main adverse events, but the side effects did not require treatment. The number of white blood cells in most donors dropped to normal levels within 1 week after apheresis. Nearly 97% of patients achieved neutrophil and platelet engraftment. Pegfilgrastim for mobilization could be used to obtain an optimal number of CD34+ cells in a single session. Pegfilgrastim-induced mobilization not only was effective and safe but also avoided the pain of multiple injections and apheresis procedures in donors. However, prospective randomized controlled trials should be conducted in the future.
使用粒细胞集落刺激因子动员造血干细胞（HSCs）是一种经典方法。最近，在一些小样本研究中，单次注射培非格司亭用于动员CD34+细胞。为了证实培非格司亭在动员健康供者CD34+细胞方面的疗效和安全性，我们进行了一项回顾性多中心研究。共有146名健康供者参与了我们的研究，他们均在第1天接受了皮下注射培非格司亭（12毫克）。在第5天进行供者造血干细胞单采。主要终点是在单次单采过程中收集到≥4×10 CD34+细胞/kg的供者百分比。供者CD34+细胞的中位数在第5天显著高于第4天（82.26 μL对51.65 μL，P＜0.001）。在146名供者中的111名中，在单次单采程序中收集到了最佳数量的CD34+细胞（≥4×10/kg）。骨痛和头痛是主要不良事件，但这些副作用无需治疗。大多数供者的白细胞数量在单采后1周内降至正常水平。近97%的患者实现了中性粒细胞和血小板植入。用于动员的培非格司亭可在单次采集中获得最佳数量的CD34+细胞。培非格司亭诱导的动员不仅有效且安全，还避免了供者多次注射和单采程序的痛苦。然而，未来应进行前瞻性随机对照试验。
