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[美卡培格司亭在血液系统肿瘤患者外周血造血干细胞动员中的应用及动员不佳的预测因素分析]

[Application of Mecapegfilgrastim for Peripheral Blood Hematopoietic Stem Cell Mobilization in Patients With Hematologic Neoplasms and Analysis of Predictors for Poor Mobilization].

作者信息

Wen Jing-Jing, Shi Lin, Xu Fang, Zhou Qiao-Lin, Liu Yi-Ping, Su Jing, Zhang Ya, Qu Wen, Yue Jing, Liang Xiao-Gong, Hu Hong

机构信息

Department of Hematology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 May;54(3):625-630. doi: 10.12182/20230560103.

Abstract

OBJECTIVE

To evaluate the efficacy of applying mecapegfilgrastim for peripheral blood hematopoietic stem cell (PBSC) mobilization in patients with hematologic neoplasms, and to investigate the influencing factors of PBSC collection.

METHODS

Patients who underwent PBSC mobilization in the Department of Hematology, Mianyang Central Hospital between April 2016 and May 2022 were retrospectively analyzed. The CD34 cell collection results of two groups, the mecapegfilgrastim group ( =28), or the PEG group, and the recombinant human granulocyte colony-stimulating factor (rhG-CSF) group ( =30), were compared, and the influencing factors of collection failure were analyzed.

RESULTS

The success rates of CD34 cells collection in the PEG group and the rhG-CSF group were 75.0% and 63.3%, respectively ( >0.05). The median CD34 cell counts were 3.37×10 /kg and 2.68×10 /kg, respectively, showing no significant difference. After combined mobilization with plerixafor, the median counts of CD34 cells collected in the PEG group and rhG-CSF group were 4.23×10 /kg and 3.26×10 /kg, respectively, showing no significant difference ( >0.05). There was no significant difference in hematopoietic system reconstruction and infections between the two groups ( >0.05). Multivariate analysis found non-plasma cell disease (odds ratio [ ]=19.697, 95% confidence interval [ ] : 1.501-258.537, =0.023), anemia before collection ( =18.571, 95% : 1.354-254.775, =0.029) and white blood cell count before collection under 32×10 L ( =85.903, 95% : 4.947-1491.807, =0.002) to be independent risk factors for PBSC collection failure.

CONCLUSION

The effect of PBSC mobilization with mecapegfilgrastim was comparable to that of rhG-CSF in patients with hematologic neoplasms. Furthermore, combined mobilization with plerixafor was feasible and effective. Patients with leukemia or lymphoma, anemia, and WBC<32×10 L before stem cell collection have a high probability of PBSC collection failure.

摘要

目的

评估美卡培格司亭用于动员血液系统恶性肿瘤患者外周血造血干细胞(PBSC)的疗效,并探讨PBSC采集的影响因素。

方法

回顾性分析2016年4月至2022年5月在绵阳市中心医院血液科接受PBSC动员的患者。比较美卡培格司亭组(n = 28)或聚乙二醇(PEG)组与重组人粒细胞集落刺激因子(rhG-CSF)组(n = 30)两组的CD34⁺细胞采集结果,并分析采集失败的影响因素。

结果

PEG组和rhG-CSF组CD34⁺细胞采集成功率分别为75.0%和63.3%(P > 0.05)。CD34⁺细胞中位数计数分别为3.37×10⁶/kg和2.68×10⁶/kg,差异无统计学意义。联合普乐沙福动员后,PEG组和rhG-CSF组采集的CD34⁺细胞中位数计数分别为4.23×10⁶/kg和3.26×10⁶/kg,差异无统计学意义(P > 0.05)。两组造血系统重建和感染情况差异无统计学意义(P > 0.05)。多因素分析发现非浆细胞病(比值比[OR]=19.697,95%置信区间[CI]:1.501 - 258.537,P = 0.023)、采集前贫血(OR = 18.571,95%CI:1.354 - 254.775,P = 0.029)和采集前白细胞计数低于32×10⁹/L(OR = 85.903,95%CI:4.947 - 1491.807,P = 0.002)是PBSC采集失败的独立危险因素。

结论

美卡培格司亭动员PBSC的效果与rhG-CSF在血液系统恶性肿瘤患者中相当。此外,联合普乐沙福动员可行且有效。白血病或淋巴瘤患者、贫血患者以及干细胞采集前白细胞计数<32×10⁹/L的患者PBSC采集失败概率较高。

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