Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Mildred Scheel Career Center HaTriCS4, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Bone Marrow Transplant. 2022 May;57(5):729-733. doi: 10.1038/s41409-022-01614-9. Epub 2022 Feb 21.
High-dose chemotherapy (HD-Cx) in refractory germ cell cancer (GCC) is effective but limited data are available concerning the optimal approach for stem cell mobilization (SCM) in these patients. In this analysis 102 patients undergoing SCM during first (n = 25) or subsequent treatment lines (n = 77) were analyzed. Subcutaneous injections of granulocyte colony-stimulating factor (G-CSF) were given once daily (group 1) in 52 patients (51%), twice daily (group 2) in 39 patients (38%) or one injection Pegylated-G-CSF (PegG-CSF) (group 3) in eleven patients (11%) after one cycle of mobilization chemotherapy. Plerixafor was administered 13 times in group 1, seven times in group 2 and once in group 3. Overall, 77 (75%) patients achieved successful SCM defined as ≥8*10 CD34+ cells/kg body weight for three consecutive HD-Cx plus one backup dose. In group 1, 40 of 52 patients (77%) achieved successful SCM with a median of 11 G-CSF injections, in group 2, 27 of 39 patients (69%) with a median of 14 G-CSF injections and in group 3, 10 of 11 patients (91%) with one injection of PegG-CSF. SCM was more successful if conducted during first-line chemotherapy (p = 0.016) and associated with a beneficial outcome concerning overall survival (p = 0.02) if performed satisfactorily.
高剂量化疗 (HD-Cx) 对难治性生殖细胞癌 (GCC) 有效，但关于这些患者干细胞动员 (SCM) 的最佳方法的数据有限。在这项分析中，对 102 名接受 SCM 的患者进行了分析，这些患者处于一线 (n=25) 或后续治疗线 (n=77)。52 名患者 (51%) 接受了一次皮下注射粒细胞集落刺激因子 (G-CSF)（第 1 组），39 名患者 (38%) 接受了两次每日皮下注射 (第 2 组)，11 名患者 (11%) 接受了一次动员化疗后给予聚乙二醇化 G-CSF (PegG-CSF) 注射 (第 3 组)。第 1 组中使用了培非格司亭 13 次，第 2 组中使用了 7 次，第 3 组中使用了 1 次。总体而言，77 (75%) 名患者成功进行了 SCM，定义为连续三次 HD-Cx 后至少 8*10 CD34+细胞/kg 体重，且至少一次备用剂量。第 1 组中，52 名患者中有 40 名 (77%) 成功进行了 SCM，中位数为 11 次 G-CSF 注射，第 2 组中，39 名患者中有 27 名 (69%) 成功进行了 SCM，中位数为 14 次 G-CSF 注射，第 3 组中，11 名患者中有 10 名 (91%) 成功进行了一次 PegG-CSF 注射。如果在一线化疗期间进行 SCM，则成功率更高 (p=0.016)，并且如果 SCM 效果满意，则对总生存有益 (p=0.02)。
