标准剂量和高剂量 G-CSF 动员患者和健康供者造血祖细胞的比较。

Comparison Between Standard and High Dose of G-CSF for Mobilization of Hematopoietic Progenitors Cells in Patients and Healthy Donors.

机构信息

Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain; Department of Hematology and Hemotherapy, Hospital Ramón y Cajal, Madrid, Spain.

Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain.

出版信息

Transfus Med Rev. 2022 Jul;36(3):159-163. doi: 10.1016/j.tmrv.2022.06.004. Epub 2022 Jun 18.

DOI:10.1016/j.tmrv.2022.06.004

PMID:35922368

Abstract

A standard dose of 10 µg/kg/day granulocyte colony stimulating factors (G-CSF) is currently recommended for hematopoietic progenitor cells (HPCs) mobilization. Our aim was to analyze whether certain patients or healthy donors could benefit from high dose of G-CSF.We performed a retrospective multicenter analysis of HPCs mobilization procedures (2015-2020) in patients and healthy donors. Those who received standard dose of G-CSF (10 µg/Kg/day for 4 days to patients and healthy donors) and those that received higher dose (24 µg/Kg/day for 4 days to patients and 16 µg/Kg/day for 4 days to healthy donors) were compared.496 individuals were included (201 standard dose and 295 higher dose). Between standard or higher dose, we did not find significant differences in median number of mobilized CD34+ cells/mL, neither among healthy donors (77 100 vs 75 500 respectively, P = .895), nor in patients (34 270 vs 33 704 respectively, P = .584). Additionally, among those with the same underlaying pathology the comparison between standard and higher dose did not showed differences. High G-CSF dose was not associated with a less frequent incidence of poor mobilizers (<20 000 CD34+ cells/mL) neither in healthy donors (1 [1.3%] vs 0; P = .218) nor patients (30 [24.4%] vs 32 [18.1%]; P = .165). Multivariate analysis showed that age, gender, and G-CSF dose did not influence median number of mobilized CD34+ cells/mL in healthy donors or patients. However, the underlying pathology among patients significantly influenced the CD34+ cells mobilization. In healthy donors, cellular blood count showed significantly higher leukocytes and platelets count with G-CSF high-dose, while in patients just a higher platelets count was found. To conclude, high dose of G-CSF compared to standard dose did not show significant benefit in terms of mobilization of CD34+ cells in healthy donors or in patients, also without a decrease in the incidence of poor mobilizers.

摘要

目前推荐标准剂量 10μg/kg/天的粒细胞集落刺激因子（G-CSF）用于造血祖细胞（HPC）动员。我们的目的是分析某些患者或健康供者是否可以从高剂量 G-CSF 中获益。我们对 2015 年至 2020 年患者和健康供者的 HPC 动员程序进行了回顾性多中心分析。将接受标准剂量 G-CSF（患者和健康供者每天 10μg/kg，连续 4 天）和高剂量 G-CSF（患者每天 24μg/kg，连续 4 天；健康供者每天 16μg/kg，连续 4 天）的患者和健康供者进行比较。共纳入 496 例患者（标准剂量组 201 例，高剂量组 295 例）。在标准剂量和高剂量组之间，我们未发现动员的 CD34+细胞/ml 中位数有显著差异，无论是在健康供者中（分别为 77100 个/ml 和 75500 个/ml，P=0.895），还是在患者中（分别为 34270 个/ml 和 33704 个/ml，P=0.584）。此外，对于相同的基础病理，标准剂量和高剂量之间的比较也没有显示出差异。高剂量 G-CSF 并未导致健康供者（不良动员者<20000 CD34+细胞/ml 的发生率更低）或患者（不良动员者<20000 CD34+细胞/ml 的发生率更低）（健康供者分别为 1[1.3%]和 0；P=0.218）或患者（分别为 30[24.4%]和 32[18.1%]；P=0.165）不良动员者的发生率降低。多变量分析表明，年龄、性别和 G-CSF 剂量并未影响健康供者或患者动员的 CD34+细胞/ml 的中位数。然而，患者的基础病理显著影响 CD34+细胞的动员。在健康供者中，高剂量 G-CSF 导致白细胞和血小板计数明显升高，而在患者中仅发现血小板计数升高。总之，与标准剂量相比，高剂量 G-CSF 并未在健康供者或患者中显示出在动员 CD34+细胞方面的显著益处，也没有降低不良动员者的发生率。