Dmitri Rogachev National Research Centre for Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russian Federation, Moscow, Russia.
J Clin Apher. 2021 Aug;36(4):547-552. doi: 10.1002/jca.21891. Epub 2021 Mar 8.
Collection of a large number of early hematopoietic progenitors is essential for allogeneic apheresis products intended for TCR-alpha/beta depletion.
We added plerixafor 0.24 mg/kg body weight (bw) on day 4 of high-dose filgrastim mobilization 10 hours prior to apheresis in 16 (30.5%) pediatric allogeneic donors who failed to recover a sufficient number of CD34+ cells.
On day 4 of G-CSF, the median CD34+ cell count in peripheral blood was 6 per μL (range 4-9 per μL) in 6 poor mobilizers and 16 per μL (range 12-19 per μL) in insufficient mobilizers. In all donors, the threshold of 50 CD34+ cells/μL was achieved, and the median increase was 14.8-fold in poor mobilizers and 6.5-fold in insufficient mobilizers, whereas it was 3.45-fold increase in those mobilized with G-CSF alone.
In all donors, a predefined number of >10 × 10 CD34+ cells/kg of recipient bw before depletion was reached in the apheresis product. The use of plerixafor did not affect the purity of further TCR-alpha/beta depletion. Side effects were mild to moderate and consisted of nausea and vomiting.
Thus, the safety and high efficacy of plerixafor was proven in healthy pediatric allogeneic hematopoietic cell donors.
为了进行 TCR-α/β 耗竭，需要采集大量早期造血祖细胞，这对于异基因单采产物至关重要。
我们在高剂量粒细胞集落刺激因子动员的第 4 天，于单采前 10 小时给 16 名（30.5%）未能采集到足够数量 CD34+细胞的儿童异基因供者添加了 0.24mg/kg 体重的plerixafor。
在 G-CSF 的第 4 天，6 名动员不佳者外周血中 CD34+细胞计数中位数为 6 个/μL（范围 4-9 个/μL），16 名动员不足者为 16 个/μL（范围 12-19 个/μL）。在所有供者中，均达到了 50 CD34+细胞/μL 的阈值，动员不佳者的中位数增加了 14.8 倍，动员不足者增加了 6.5 倍，而单独使用 G-CSF 者增加了 3.45 倍。
在所有供者中，在单采产物中达到了受体体重 10×10 CD34+细胞/公斤的预定数量。plerixafor 的使用并未影响进一步 TCR-α/β 耗竭的纯度。副作用为轻至中度，包括恶心和呕吐。
因此，plerixafor 在健康的儿童异基因造血细胞供者中具有安全性和高效性。
