Wang Guo-Rong, Yang Guang-Zhong, Leng Yun, Wu Yin, Liu Ai-Jun, Chen Wen-Ming
Department of Hematology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing Medical Research Center for Multiple Myeloma, Beijing 100020, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2025 Apr;33(2):455-462. doi: 10.19746/j.cnki.issn.1009-2137.2025.02.021.
To analyze the effect of COVID-19 infection on the mobilization and collection of autologous peripheral blood stem cells in patients with multiple myeloma.
The general baseline data, treatment factors before mobilization collection, collection status, and treatment overview after collection of autologous peripheral blood stem cells at Beijing Chaoyang Hospital affiliated with Capital Medical University from January 1, 2020 to July 15, 2023 were analyzed.
269 patients underwent mobilization and collection of autologous peripheral blood stem cells. Among them, 32 cases with COVID-19 infection history (COVID-19 group) and 237 cases without COVID-19 infection history (non-COVID-19 group). In the COVID-19 group, 17 cases were treated with chemotherapy (etoposide)+G-CSF, and 15 cases were treated with plerixafor +G-CSF. In the non-COVID-19 group, 214 cases were treated with chemotherapy +G-CSF, 17 cases were treated with plerixafor +G-CSF, and 6 cases were treated with chemotherapy + plerixafor +G-CSF. The number of CD34 cells, collection success rate, and excellence rate in the COVID-19 group and the non-COVID-19 group were [5.52 (0.94-26.87) 4.80 (0.53-37.20)]×10/kg ( =0.610), (93.8% 85.2%) ( =0.275), (62.5% 49.4%) ( =0.190), respectively. Among 113 patients mobilized with etoposide +G-CSF, the number of CD34 cells, success rate, and excellence rate collected from COVID-19 infection (17 cases) and non-COVID-19 infection (96 cases) were [7.54 (2.66-26.87) 7.78 (2.26-37.20)]×10/kg ( =0.847), (100.0% 100.0%) (no value), (82.4% 86.5%) ( =0.655), respectively. Among 32 patients mobilized by plerixafor +G-CSF, the number of CD34 cells, success rate and excellence rate of COVID-19 infection (15 cases) and non-COVID-19 infection (17 cases) were [3.82 (0.94-7.27) 4.11 (0.53-9.05)]×10/kg ( =0.821), (86.7% 88.2%) ( =0.893), (40.0% 35.3%) ( =0.784), respectively. In 32 patients with COVID-19 infection, the number of CD34 cells collected by etoposide +G-CSF (17 cases) and plerixafor +G-CSF (15 cases), as well as the success rate and excellence rate were [7.54 (2.66-26.87) 3.82(0.94-7.27)]×10/kg ( =0.004), (100.0% 86.7%) ( =0.120), (82.4% 40.0%) ( =0.014), respectively. By 2023.7.31, 232 patients (86.2%, 232/269) had received transplantation, including 24 patients in the COVID-19 group and 208 patients in the non-COVID-19 group. The median number of CD34 cells infused in the two groups was [3.67 (2.50-13.44) 3.11(1.12-19.89)]×10/kg ( =0.058), the median days of neutrophil engraftment [11(9-13) 11(9-17)] ( =0.674), the median days of platelet engraftment [11(0-23), 12(0-43)] ( =0.279), respectively.
The history of COVID-19 infection did not affect the PBSC mobilization, collection and transplantation of patients with myeloma. In patients with COVID-19 infection, the results of chemotherapy mobilization with etoposide seems to be better than that of plerixafor mobilization, but further research is needed to clarify.
分析新型冠状病毒肺炎(COVID-19)感染对多发性骨髓瘤患者自体外周血干细胞动员及采集的影响。
分析2020年1月1日至2023年7月15日在首都医科大学附属北京朝阳医院进行自体外周血干细胞动员采集的一般基线资料、动员采集前的治疗因素、采集情况及采集后的治疗概况。
269例患者进行了自体外周血干细胞的动员及采集。其中,有COVID-19感染史的32例(COVID-19组),无COVID-19感染史的237例(非COVID-19组)。COVID-19组中,17例接受化疗(依托泊苷)+粒细胞集落刺激因子(G-CSF)治疗,15例接受普乐沙福+G-CSF治疗。非COVID-19组中,214例接受化疗+G-CSF治疗,17例接受普乐沙福+G-CSF治疗,6例接受化疗+普乐沙福+G-CSF治疗。COVID-19组与非COVID-19组的CD34细胞数量、采集成功率及优质率分别为[5.52(0.94 - 26.87) 4.80(0.53 - 37.20)]×10⁶/kg(P = 0.610),(93.8% 85.2%)(P = 0.275),(62.5% 49.4%)(P = 0.190)。在113例接受依托泊苷+G-CSF动员的患者中,COVID-19感染患者(17例)与非COVID-19感染患者(96例)采集的CD34细胞数量、成功率及优质率分别为[7.54(2.66 - 26.87) 7.78(2.26 - 37.20)]×10⁶/kg(P = 0.847),(100.0% 100.0%)(无P值),(82.4% 86.5%)(P = 0.655)。在32例接受普乐沙福+G-CSF动员的患者中,COVID-19感染患者(15例)与非COVID-19感染患者(17例)的CD34细胞数量、成功率及优质率分别为[3.82(0.94 - 7.27) 4.11(0.53 - 9.05)]×10⁶/kg(P = 0.821),(86.7% 88.2%)(P = 0.893),(40.0% 35.3%)(P = 0.784)。在32例COVID-19感染患者中,依托泊苷+G-CSF(17例)与普乐沙福+G-CSF(15例)采集的CD34细胞数量以及成功率和优质率分别为[7.54(2.66 - 26.87) 3.82(0.94 - 7.27)]×10⁶/kg(P = 0.004),(100.0% 86.7%)(P = 0.120),(82.4% 40.0%)(P = 0.014)。截至2023年7月31日,232例患者(86.2%,232/269)接受了移植,其中COVID-19组24例,非COVID-19组208例。两组输注的CD34细胞数量中位数分别为[3.67(2.50 - 13.44) 3.11(1.12 - 19.89)]×10⁶/kg(P = 0.058),中性粒细胞植入中位数天数分别为[11(9 - 13) 11(9 - 17)](P = 0.674),血小板植入中位数天数分别为[11(0 - 23),12(0 - 43)](P = 0.279)。
COVID-19感染史不影响骨髓瘤患者外周血干细胞的动员、采集及移植。在COVID-19感染患者中,依托泊苷化疗动员效果似乎优于普乐沙福动员,但尚需进一步研究明确。