Aurlien E, Holte H, Pharo A, Kvaløy S, Jakobsen E, Smeland E B, Kvalheim G
University Hospital, The Norwegian Radium Hospital, Montebello, Oslo.
Bone Marrow Transplant. 1998 May;21(9):873-8. doi: 10.1038/sj.bmt.1701192.
Many centers use CY and G-CSF to mobilize PBPC. In this study we explored whether a standard chemotherapy regimen consisting of mitoguazon, ifosfamide, MTX and etoposide (MIME) combined with G-CSF was capable of mobilizing PBPC in lymphoma patients. Twelve patients with Hodgkin's disease (HD) and 38 patients with non-Hodgkin's lymphoma (NHL) were mobilized with MIME/G-CSF. Most patients were heavily treated with different chemotherapy regimens receiving a median of 11 cycles (range 3 to 20) of chemotherapy prior to mobilization. It was found that the optimal time of PBPC harvest was at days 12 and 13 after initiating the mobilization regimen. The median number of collected CD34+ cells per kg body weight was 7.1 x 10(6) (range 0.5-26.2). More than 2.0 x 10(6) CD34+ cells/kg were achieved in 69% of the patients after one apheresis. When additional cycles of apheresis were done, only 6% failed to harvest this number of CD34+ cells. There was a statistically significant inverse correlation between the number of prior chemotherapy cycles and CD34+ cell yield (P = 0.003). No such association was found between CD34+ cell yield and prior radiotherapy. When MIME/G-CSF was compared with Dexa-BEAM/G-CSF, it was found that MIME/G-CSF tended to be more efficient in mobilizing PBPC in spite of being less myelotoxic. All patients transplanted with MIME/G-CSF mobilized PBPC had fast and sustained engraftment. These results demonstrate that an ordinary salvage chemotherapy regimen, such as MIME combined with G-CSF can be successfully used to mobilize PBPC.
许多中心使用环磷酰胺（CY）和粒细胞集落刺激因子（G-CSF）来动员外周血造血干细胞（PBPC）。在本研究中，我们探讨了由米托胍腙、异环磷酰胺、甲氨蝶呤（MTX）和依托泊苷组成的标准化疗方案（MIME）联合G-CSF是否能够动员淋巴瘤患者的PBPC。12例霍奇金淋巴瘤（HD）患者和38例非霍奇金淋巴瘤（NHL）患者接受了MIME/G-CSF动员。大多数患者在动员前接受了不同化疗方案的大量治疗，化疗周期中位数为11个周期（范围3至20个周期）。结果发现，PBPC采集的最佳时间是在启动动员方案后的第12天和第13天。每千克体重采集的CD34+细胞中位数为7.1×10⁶（范围0.5 - 26.2）。一次单采后，69%的患者获得了超过2.0×10⁶个/kg的CD34+细胞。当进行额外的单采周期时，只有6%的患者未能采集到这个数量的CD34+细胞。既往化疗周期数与CD34+细胞产量之间存在统计学显著的负相关（P = 0.003）。在CD34+细胞产量与既往放疗之间未发现此类关联。当将MIME/G-CSF与地塞米松-卡莫司汀、依托泊苷、阿糖胞苷、美法仑（Dexa-BEAM）/G-CSF进行比较时，发现尽管MIME/G-CSF的骨髓毒性较小，但在动员PBPC方面往往更有效。所有接受MIME/G-CSF动员的PBPC进行移植的患者均实现了快速且持续的植入。这些结果表明，一种普通的挽救性化疗方案，如MIME联合G-CSF可成功用于动员PBPC。
