一种新型聚乙二醇化的粒细胞集落刺激因子，美泊利珠单抗，用于血液系统恶性肿瘤患者的外周血造血干细胞动员。
A novel PEGylated form of granulocyte colony-stimulating factor, mecapegfilgrastim, for peripheral blood stem cell mobilization in patients with hematologic malignancies.
机构信息
Department of Hematology, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, No 12. Changjia alley, Jingzhong Street, Fucheng district, Mianyang, 621000, China.
Department of Hematology of Beijing Friendship Hospital, Capital Medical University, Beijing, 100000, China.
出版信息
BMC Cancer. 2023 Jul 24;23(1):694. doi: 10.1186/s12885-023-11197-3.
BACKGROUND
The Pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) has longer half-life and is given once only, which is more comfortable for patients. We aimed to evaluate the efficacy of mecapegfilgrastim for hematopoietic stem cell (HSC) mobilization in patients with hematologic malignancies and to explore the potential factors related to HSC mobilization.
METHODS
A retrospective analysis was performed on patients who underwent HSC mobilization in the hematology department of Mianyang Central Hospital from April 2016 to November 2022. The number of CD34 + cells collected was compared between the patients receiving mecapegfilgrastim (PEG group) and those receiving recombinant human granulocyte colony-stimulating factor (rhG-CSF group), and the possible factors for mobilization failure were analyzed.
RESULTS
The success rates of collecting CD34 + cells in the PEG group and rhG-CSF group were 80.6% and 67.7%, respectively (χ = 1.444, P = 0.229). The median CD34 + cell counts were 3.62 × 10^6/kg and 2.92 × 10^6/kg (P = 0.178), respectively. After combination with plerixafor for mobilization, the median number of CD34 + cells collected in the PEG group and rhG-CSF group were 3.64 × 10^6/kg and 3.92 × 10^6/kg, respectively, with no significant difference (P = 0.754). There was no significant difference in hematopoietic cell recovery or infection between the groups (P > 0.05). Multivariate analysis showed that more than 5 cycles of chemotherapy (OR = 15.897, 95% CI: 1.766-143.127, P = 0.014), a precollection WBC count < 32 × 10^9/L (OR = 14.441, 95% CI: 2.180-95.657, P = 0.006) and a precollection to premobilization lymphocyte ratio < 1.7 (OR = 11.388, 95% CI: 2.129-60.915, P = 0.004) were independent risk factors for HSC mobilization failure.
CONCLUSIONS
The HSC mobilization efficacy of mecapegfilgrastim in patients with hematologic malignancies was comparable to that of rhG-CSF, and combination with plerixafor for mobilization was feasible and effective. Patients with more than 5 cycles of chemotherapy before HSC mobilization, a precollection WBC count lower than 32 × 10^9/L, and a precollection lymphocyte count less than 1.7 times the premobilization lymphocyte count have a high probability of HSC mobilization failure.
背景
聚乙二醇化重组人粒细胞集落刺激因子（PEG-rhG-CSF）半衰期更长，只需一次给药，对患者更为舒适。我们旨在评估米卡芬净在血液系统恶性肿瘤患者造血干细胞（HSC）动员中的疗效，并探讨与 HSC 动员相关的潜在因素。
方法
对 2016 年 4 月至 2022 年 11 月在绵阳市中心医院血液科接受 HSC 动员的患者进行回顾性分析。比较接受米卡芬净（PEG 组）和接受重组人粒细胞集落刺激因子（rhG-CSF 组）的患者收集的 CD34+细胞数量，并分析动员失败的可能因素。
结果
PEG 组和 rhG-CSF 组的 CD34+细胞采集成功率分别为 80.6%和 67.7%（χ2=1.444，P=0.229）。CD34+细胞中位数分别为 3.62×10^6/kg 和 2.92×10^6/kg（P=0.178）。与普乐沙福联合动员后，PEG 组和 rhG-CSF 组收集的 CD34+细胞中位数分别为 3.64×10^6/kg 和 3.92×10^6/kg，差异无统计学意义（P=0.754）。两组造血细胞恢复或感染无差异（P>0.05）。多因素分析显示，化疗超过 5 个周期（OR=15.897，95%CI：1.766-143.127，P=0.014）、动员前白细胞计数<32×10^9/L（OR=14.441，95%CI：2.180-95.657，P=0.006）和动员前至动员前淋巴细胞比值<1.7（OR=11.388，95%CI：2.129-60.915，P=0.004）是 HSC 动员失败的独立危险因素。
结论
米卡芬净在血液系统恶性肿瘤患者中的 HSC 动员效果与 rhG-CSF 相当，与普乐沙福联合动员是可行且有效的。在 HSC 动员前化疗超过 5 个周期、动员前白细胞计数<32×10^9/L、动员前淋巴细胞计数<1.7 倍动员前淋巴细胞计数的患者，HSC 动员失败的可能性较高。
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