Ahn Won Kee, Nam Hyun-Jun, Lee Hae Won, Hahn Seungmin, Han Jung Woo, Lyu Chuhl Joo, Kim Sinyoung, Kwon Soon Sung, Chung Haerim, Kim Jin Seok, Cheong June-Won, Lee Kyung-A
Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Republic of Korea.
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Cancers (Basel). 2024 May 10;16(10):1821. doi: 10.3390/cancers16101821.
Peripheral blood stem cell transplantation (PBSCT) is an important therapeutic measure for both hematologic and non-hematologic diseases. For PBSCT to be successful, sufficient CD34 cells need to be mobilized and harvested. Although risk factors associated with poor mobilization in patients with hematologic diseases have been reported, studies of patients with non-hematologic diseases and those receiving plerixafor are rare. To identify factors associated with poor mobilization, data from autologous PBSC harvest (PBSCH) in 491 patients were retrospectively collected and analyzed. A multivariate analysis revealed that in patients with a hematologic disease, an age older than 60 years (odds ratio [OR] 1.655, 95% confidence interval [CI] 1.049-2.611, = 0.008), the use of myelotoxic agents (OR 4.384, 95% CI 2.681-7.168, < 0.001), and a low platelet count (OR 2.106, 95% CI 1.205-3.682, = 0.009) were associated with poor mobilization. In patients with non-hematologic diseases, a history of radiation on the pelvis/spine was the sole associated factor (OR 12.200, 95% CI 1.934-76.956, = 0.008). Among the group of patients who received plerixafor, poor mobilization was observed in 19 patients (19/134, 14.2%) and a difference in the mobilization regimen was noted among the good mobilization group. These results show that the risk factors for poor mobilization in patients with non-hematologic diseases and those receiving plerixafor differ from those in patients with hematologic diseases; as such, non-hematologic patients require special consideration to enable successful PBSCH.
外周血干细胞移植（PBSCT）是治疗血液系统疾病和非血液系统疾病的一项重要治疗措施。为使PBSCT取得成功，需要动员并采集足够数量的CD34细胞。尽管已有报道指出血液系统疾病患者动员效果不佳的相关危险因素，但关于非血液系统疾病患者以及使用普乐沙福的患者的研究却很少。为了确定与动员效果不佳相关的因素，我们回顾性收集并分析了491例患者自体PBSC采集（PBSCH）的数据。多因素分析显示，在血液系统疾病患者中，年龄大于60岁（比值比[OR] 1.655，95%置信区间[CI] 1.049 - 2.611，P = 0.008）、使用骨髓毒性药物（OR 4.384，95% CI 2.681 - 7.168，P < 0.001）以及血小板计数低（OR 2.106，95% CI 1.205 - 3.682，P = 0.009）与动员效果不佳相关。在非血液系统疾病患者中，骨盆/脊柱接受过放疗史是唯一相关因素（OR 12.200，95% CI 1.934 - 76.956，P = 0.008）。在接受普乐沙福的患者组中，19例患者（19/134，14.2%）动员效果不佳，且在动员效果良好的组中观察到动员方案存在差异。这些结果表明，非血液系统疾病患者以及使用普乐沙福的患者动员效果不佳的危险因素与血液系统疾病患者不同；因此，非血液系统疾病患者需要特别考虑，以实现成功的PBSCH。
