Ji M M, Shen Y G, Gong J C, Tang W, Xu X Q, Zheng Z, Chen S Y, He Y, Zheng X, Zhao L D, Zhao W L, Wu W
Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Zhonghua Xue Ye Xue Za Zhi. 2023 Feb 14;44(2):112-117. doi: 10.3760/cma.j.issn.0253-2727.2023.02.005.
To evaluate the advantages and safety of Plerixafor in combination with granulocyte colony-stimulating factor (G-CSF) in autologous hematopoietic stem cell mobilization of lymphoma. Lymphoma patients who received autologous hematopoietic stem cell mobilization with Plerixafor in combination with G-CSF or G-CSF alone were obtained. The clinical data, the success rate of stem cell collection, hematopoietic reconstitution, and treatment-related adverse reactions between the two groups were evaluated retrospectively. A total of 184 lymphoma patients were included in this analysis, including 115 cases of diffuse large B-cell lymphoma (62.5%) , 16 cases of classical Hodgkin's lymphoma (8.7%) , 11 cases of follicular non-Hodgkin's lymphoma (6.0%) , 10 cases of angioimmunoblastic T-cell lymphoma (5.4%) , 6 cases of mantle cell lymphoma (3.3%) , and 6 cases of anaplastic large cell lymphoma (3.3%) , 6 cases of NK/T-cell lymphoma (3.3%) , 4 cases of Burkitt's lymphoma (2.2%) , 8 cases of other types of B-cell lymphoma (4.3%) , and 2 cases of other types of T-cell lymphoma (1.1%) ; 31 patients had received radiotherapy (16.8%) . The patients in the two groups were recruited with Plerixafor in combination with G-CSF or G-CSF alone. The baseline clinical characteristics of the two groups were basically similar. The patients in the Plerixafor in combination with the G-CSF mobilization group were older, and the number of recurrences and third-line chemotherapy was higher. 100 patients were mobilized with G-CSF alone. The success rate of the collection was 74.0% for one day and 89.0% for two days. 84 patients in the group of Plerixafor combined with G-CSF were recruited successfully with 85.7% for one day and 97.6% for two days. The success rate of mobilization in the group of Plerixafor combined with G-CSF was substantially higher than that in the group of G-CSF alone (=0.023) . The median number of CD34(+) cells obtained in the mobilization group of Plerixafor combined with G-CSF was 3.9×10(6)/kg. The median number of CD34(+) cells obtained in the G-CSF Mobilization group alone was 3.2×10(6)/kg. The number of CD34(+) cells collected by Plerixafor combined with G-CSF was considerably higher than that in G-CSF alone (=0.001) . The prevalent adverse reactions in the group of Plerixafor combined with G-CSF were grade 1-2 gastrointestinal reactions (31.2%) and local skin redness (2.4%) . The success rate of autologous hematopoietic stem cell mobilization in lymphoma patients treated with Plerixafor combined with G-CSF is significantly high. The success rate of collection and the absolute count of CD34(+) stem cells were substantially higher than those in the group treated with G-CSF alone. Even in older patients, second-line collection, recurrence, or multiple chemotherapies, the combined mobilization method also has a high success rate of mobilization.
评估普乐沙福联合粒细胞集落刺激因子（G-CSF）用于淋巴瘤患者自体造血干细胞动员的优势及安全性。选取接受普乐沙福联合G-CSF或单用G-CSF进行自体造血干细胞动员的淋巴瘤患者。回顾性评估两组患者的临床资料、干细胞采集成功率、造血重建情况及治疗相关不良反应。本分析共纳入184例淋巴瘤患者，其中弥漫性大B细胞淋巴瘤115例（62.5%）、经典型霍奇金淋巴瘤16例（8.7%）、滤泡性非霍奇金淋巴瘤11例（6.0%）、血管免疫母细胞性T细胞淋巴瘤10例（5.4%）、套细胞淋巴瘤6例（3.3%）、间变性大细胞淋巴瘤6例（3.3%）、NK/T细胞淋巴瘤6例（3.3%）、伯基特淋巴瘤4例（2.2%）、其他类型B细胞淋巴瘤8例（4.3%）、其他类型T细胞淋巴瘤2例（1.1%）；31例患者曾接受过放疗（16.8%）。两组患者分别采用普乐沙福联合G-CSF或单用G-CSF进行动员。两组患者的基线临床特征基本相似。普乐沙福联合G-CSF动员组患者年龄较大，复发次数及接受三线化疗的比例更高。单用G-CSF动员的患者有100例。采集成功率1天为74.0%，2天为89.0%。普乐沙福联合G-CSF组84例患者成功动员，1天成功率为85.7%，2天成功率为97.6%。普乐沙福联合G-CSF组的动员成功率显著高于单用G-CSF组（P=0.023）。普乐沙福联合G-CSF动员组获得的CD34(+)细胞中位数为3.9×10(6)/kg。单用G-CSF动员组获得的CD34(+)细胞中位数为3.2×10(6)/kg。普乐沙福联合G-CSF采集的CD34(+)细胞数量显著高于单用G-CSF组（P=0.001）。普乐沙福联合G-CSF组常见的不良反应为1-2级胃肠道反应（31.2%）和局部皮肤发红（2.4%）。普乐沙福联合G-CSF治疗的淋巴瘤患者自体造血干细胞动员成功率显著更高。采集成功率及CD34(+)干细胞绝对计数均显著高于单用G-CSF治疗组。即使是老年患者、二线采集、复发或接受多次化疗的患者，联合动员方法也具有较高的动员成功率。
