Chen Juan, Yuan Li-Li, Zhang Xian, Qiao Jia-Li, Yin Qing-Xue, Zhang Yue-Mei, Yang Xue-Lian, Cao Xing-Yu
Blood Cell Room, Hebei Yanda Lu Daopei Hospital, Langfang 065201, Hebei Province, China.
Department of Laboratory Medicine, Hebei Yanda Lu Daopei Hospital, Langfang 065201, Hebei Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Feb;30(1):286-291. doi: 10.19746/j.cnki.issn.1009-2137.2022.01.047.
To study the effect and safety of G-CSF combined with Plerixafor on the mobilization of peripheral blood hematopoietic stem cells from healthy related donors of allogeneic hematopoietic stem cell transplantation (allo-HSCT).
It was analyzed retrospectively that the data of peripheral blood hematopoietic stem cells from 33 (observation group) related donors mobilized by G-CSF plus Plerixafor in Hebei Yanda Lu Daopei Hospital from April 2019 to April 2021. Bone marrow and peripheral blood hematopoietic stem cells (PBSCs) of these donors were respectively collected on the fourth and fifth day of G-CSF-induced mobilization. Following the administration of Plerixafor on the night of the fifth day, PBSCs were collected on the sixth day once again. 46 donors using "G-CSF only" mobilization method in the same period were randomly selected as the control and respectively analyzed the differences of CD34+ cell counts on the fifth and the sixth day in two groups. And the donors' adverse reaction to Plerixafor in the form of questionnaire was also observed. Then it was compared that the patients who underwent allo-HSCT in "G-CSF+Plerixafor" group and "G-CSF only" group in terms of acute GVHD at grade I-IV or III-IV, CMV reactivation and EBV reactivation.
CD34+ cells count (M±Q) among PBSCs collected on the fifth and the sixth day in the observation group were (1.71±1.02)×10/kg and (4.23±2.33)×10/kg, respectively. CD34+ cell counts on the sixth day was significantly higher than that of the fifth day (P<0.001); While the counterparts in the control group were (2.47±1.60)×10/kg and (1.87±1.37)×10/kg, respectively. By statistical analysis, CD34+ cell counts on the sixth day was significantly less than that of the fifth day (P<0.001). The adverse reaction to Plerixafor for the donors in the study were all grade 1 or 2 (mild or moderate) according to CTCAE 5.0 and disappeared in a short time. The patients who underwent allo-HSCT in the "G-CSF+Plerixafor" group and "G-CSF only" group were not statistically significant in terms of acute GVHD at grade I-IV or III-IV, CMV reactivation and EBV reactivation (P>0.1).
The cell mobilization program of G-CSF combined with Plerixafor is safe and effective for being applied to allo-HSCT. The addition of Plerixafor can significantly increase the number of CD34 postive cells in the PBSC collection. Key words ; ;
研究粒细胞集落刺激因子（G-CSF）联合普乐沙福对异基因造血干细胞移植（allo-HSCT）健康相关供者外周血造血干细胞动员的效果及安全性。
回顾性分析2019年4月至2021年4月在河北燕达陆道培医院接受G-CSF加普乐沙福动员的33例（观察组）相关供者外周血造血干细胞的数据。在G-CSF动员的第4天和第5天分别采集这些供者的骨髓和外周血造血干细胞（PBSCs）。在第5天晚上给予普乐沙福后，于第6天再次采集PBSCs。同期随机选取46例采用“仅G-CSF”动员方法的供者作为对照组，分别分析两组第5天和第6天CD34+细胞计数的差异。并以问卷形式观察供者对普乐沙福的不良反应。然后比较“G-CSF+普乐沙福”组和“仅G-CSF”组接受allo-HSCT的患者在Ⅰ-Ⅳ级或Ⅲ-Ⅳ级急性移植物抗宿主病（GVHD）、巨细胞病毒（CMV）激活和EB病毒（EBV）激活方面的情况。
观察组第5天和第6天采集的PBSCs中CD34+细胞计数（M±Q）分别为（1.71±1.02）×10/kg和（4.23±2.33）×10/kg。第6天的CD34+细胞计数显著高于第5天（P<0.001）；而对照组相应的计数分别为（2.47±1.60）×10/kg和（1.87±1.37）×10/kg。经统计学分析，第6天的CD34+细胞计数显著低于第5天（P<0.001）。根据美国国立癌症研究所常见不良反应事件评价标准第5版（CTCAE 5.0），研究中供者对普乐沙福的不良反应均为1级或2级（轻度或中度），且在短时间内消失。“G-CSF+普乐沙福”组和“仅G-CSF”组接受allo-HSCT的患者在Ⅰ-Ⅳ级或Ⅲ-Ⅳ级急性GVHD、CMV激活和EBV激活方面差异无统计学意义（P>0.1）。
G-CSF联合普乐沙福的细胞动员方案应用于allo-HSCT安全有效。添加普乐沙福可显著增加PBSC采集中CD34阳性细胞的数量。 关键词 ; ;
