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普乐沙福或环磷酰胺联合粒细胞集落刺激因子用于动员多发性骨髓瘤患者外周血干细胞的比较

[Comparison of Plerixafor or Cyclophosphamide Combined with G-CSF in Mobilization of Peripheral Blood Stem Cells in Multiple Myeloma].

作者信息

Li Wan-Ting, Ma Liang-Ming, Lian Yu, Wang Quan-Gang, Gao Zhong-Jie, Zhao Shuang

机构信息

Department of Hematology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, Shanxi Province, China.

Department of Hematology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, Shanxi Province, China.E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Oct;31(5):1403-1409. doi: 10.19746/j.cnki.issn.1009-2137.2023.05.023.

Abstract

OBJECTIVE

To compare the efficacy of plerixafor (PXF) combined with granulocyte colony-stimulating factor (G-CSF) (PXF+G-CSF) and cyclophosphamide (Cy) combined with G-CSF (Cy+G-CSF) in the mobilization of peripheral blood stem cells (PBSCs) in patients with multiple myeloma (MM).

METHODS

The clinical data of 41 MM patients who underwent PBSC mobilization using PXF+G-CSF (18 cases) or Cy+G-CSF (23 cases) in Shanxi Bethune Hospital from January 2019 to December 2021 were retrospectively analyzed, including the count of collected CD34 cells, acquisition success rate, failure rate, and optimal rate. The correlation of sex, age, disease type, DS staging, ISS staging, number of chemotherapy cycle, disease status before mobilization, and mobilization regimen with the collection results was analyzed, and the adverse reactions, length of hospital stay, and hospitalization costs were compared between the two mobilization regimens.

RESULTS

The 41 patients underwent 97 mobilization collections, and the median number of CD34 cells collected was 6.09 (0-34.07)×10/kg. The acquisition success rate, optimal rate, and failure rate was 90.2%, 56.1%, and 9.8%, respectively. Univariate analysis showed that sex, age, disease type, and disease stage had no significant correlation with the number of CD34 cells collected and acquisition success rate ( >0.05), but the patients with better disease remission than partial remission before mobilization were more likely to obtain higher CD34 cell count ( <0.05). The PXF+G-CSF group had a larger number of CD34 cells and higher acquisition success rate in the first collection than Cy+G-CSF group (both <0.05), and had lower infection risk and shorter length of hospital stay during mobilization (both <0.05), but the economic burden increased ( <0.05).

CONCLUSION

PXF+G-CSF used for PBSC mobilization in MM patients has high first acquisition success rate, large number of CD34 cells, less number of collection times, and short length of hospital stay, but the economic cost is heavy.

摘要

目的

比较普乐沙福(PXF)联合粒细胞集落刺激因子(G-CSF)(PXF+G-CSF)与环磷酰胺(Cy)联合G-CSF(Cy+G-CSF)动员多发性骨髓瘤(MM)患者外周血干细胞(PBSC)的疗效。

方法

回顾性分析2019年1月至2021年12月在山西白求恩医院采用PXF+G-CSF(18例)或Cy+G-CSF(23例)进行PBSC动员的41例MM患者的临床资料,包括采集的CD34细胞计数、采集成功率、失败率和优化率。分析性别、年龄、疾病类型、DS分期、ISS分期、化疗周期数、动员前疾病状态和动员方案与采集结果的相关性,并比较两种动员方案的不良反应、住院时间和住院费用。

结果

41例患者共进行了97次动员采集,采集的CD34细胞中位数为6.09(0-34.07)×10/kg。采集成功率、优化率和失败率分别为90.2%、56.1%和9.8%。单因素分析显示,性别、年龄、疾病类型和疾病分期与采集的CD34细胞数和采集成功率无显著相关性(>0.05),但动员前疾病缓解程度优于部分缓解的患者更有可能获得更高的CD34细胞计数(<0.05)。PXF+G-CSF组首次采集的CD34细胞数量更多,采集成功率高于Cy+G-CSF组(均<0.05),动员期间感染风险更低,住院时间更短(均<0.05),但经济负担增加(<0.05)。

结论

PXF+G-CSF用于MM患者PBSC动员,首次采集成功率高,CD34细胞数量多,采集次数少,住院时间短,但经济成本高。

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