Drozd-Sokołowska Joanna, Waszczuk-Gajda Anna, Topczewska Magdalena, Maciejewska Martyna, Dutka Magdalena, Zaucha Jan Maciej, Szmigielska-Kapłon Anna, Nowicki Mateusz, Olszewska-Szopa Magdalena, Szeremet Agnieszka, Czyż Anna, Kozioł Magdalena, Hus Marek, Mańko Joanna, Hus Iwona, Romejko-Jarosińska Joanna, Kopińska Anna, Helbig Grzegorz, Mądry Krzysztof, Boguradzki Piotr, Król Małgorzata, Snarski Emilian, Hayden Patrick J, Jamroziak Krzysztof, Dwilewicz-Trojaczek Jadwiga, Basak Grzegorz Władysław
Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
Faculty of Computer Science, Bialystok University of Technology, 15-351 Bialystok, Poland.
Cancers (Basel). 2024 Jul 19;16(14):2588. doi: 10.3390/cancers16142588.
Salvage autologous hematopoietic cell transplantation (auto-HCT) may be used to treat relapse of plasma cell myeloma occurring after previous auto-HCT. When an insufficient number of hematopoietic stem cells have been stored from the initial harvest, remobilization is necessary. Here, we aimed to analyze the efficacy and safety of different doses of cytarabine (total 800 vs. 1600 vs. 2400 mg/m) for remobilization. Sixty-five patients, 55% male, with a median age at remobilization 63 years, were included. Remobilization was performed with cytarabine_800 in 7, cytarabine_1600 in 36, and cytarabine_2400 in 22 patients. Plerixafor rescue was used in 25% of patients receiving cytarabine_1600 and 27% of those receiving cytarabine_2400. Patients administered cytarabine_800 were not rescued with plerixafor. Remobilization was successful in 80% of patients (57% cytarabine_800; 86% cytarabine_1600; 77% cytarabine_2400; = 0.199). The yield of collected CD34+ cells did not differ between the different cytarabine doses ( = 0.495). Patients receiving cytarabine_2400 were at the highest risk of developing severe cytopenias, requiring blood product support, or having blood-stream infections. One patient died of septic shock after cytarabine_2400. In summary, remobilization with cytarabine is feasible in most patients. All doses of cytarabine allow for successful remobilization. Cytarabine_2400 is associated with higher toxicity; therefore, lower doses (800 or 1600 mg/m) seem to be preferable.
挽救性自体造血细胞移植（auto-HCT）可用于治疗既往auto-HCT后发生的浆细胞骨髓瘤复发。当初次采集储存的造血干细胞数量不足时，就需要进行动员。在此，我们旨在分析不同剂量阿糖胞苷（总量800 vs. 1600 vs. 2400 mg/m）用于动员的疗效和安全性。纳入了65例患者，其中55%为男性，动员时的中位年龄为63岁。7例患者使用阿糖胞苷800进行动员，36例使用阿糖胞苷1600，22例使用阿糖胞苷2400。接受阿糖胞苷1600的患者中有25%使用普乐沙福进行挽救，接受阿糖胞苷2400的患者中有27%使用。接受阿糖胞苷800的患者未使用普乐沙福进行挽救。80%的患者动员成功（阿糖胞苷800为57%；阿糖胞苷1600为86%；阿糖胞苷2400为77%；P = 0.199）。不同阿糖胞苷剂量组收集的CD34+细胞产量无差异（P = 0.495）。接受阿糖胞苷2400的患者发生严重血细胞减少、需要血液制品支持或发生血流感染的风险最高。1例患者在接受阿糖胞苷2400后死于感染性休克。总之，对大多数患者而言，用阿糖胞苷进行动员是可行的。所有剂量的阿糖胞苷均可成功动员。阿糖胞苷2400的毒性更高；因此，较低剂量（800或1600 mg/m）似乎更可取。
