文章：

普乐沙福在一线干细胞动员方面优于传统化疗，且即使在重度预处理患者中仍有效

Plerixafor is superior to conventional chemotherapy for first-line stem cell mobilisation, and is effective even in heavily pretreated patients

原文发布日期：2014-10-31

DOI: 10.1038/bcj.2014.79

类型: Original Article

开放获取: 是

英文摘要：

This study (PHANTASTIC) compares first-line plerixafor with granulocyte colony-stimulating factor (G-CSF) in 98 myeloma and lymphoma patients with 151 historic controls mobilised by conventional chemotherapy+G-CSF. Eleven patients developed mild transient symptoms possibly related to plerixafor. No serious adverse events were seen. Seventy (71%) plerixafor-mobilised patients achieved both ⩾4 × 106 CD34+ cells/kg in ⩽2 aphereses and no neutropenia (<1.0 × 109/l). This is significantly >48 (32%) of 151 historical chemotherapy+G-CSF-mobilised control patients achieving this end point (P<0.001). Ninety-six (98%) plerixafor-mobilised patients achieved ⩾2 × 106 CD34+ cells/kg within one harvest round compared with 114 (75%) of controls (P=0.001). Engraftment times and 12-month outcome were comparable in both groups. Prior treatment was summarised by two scoring systems. Controls mobilising either >2.0 or >4.0 × 106 CD34+ cells/kg have significantly lower scores than mobilisation failures (P=0.002), but this relationship was not seen for plerixafor-mobilised patients. Plerixafor is a more effective and less toxic mobilising agent than conventional chemotherapy (especially in heavily pretreated patients), with comparable subsequent outcome, and merits consideration as the first-line standard of care for stem cell mobilisation.

摘要翻译： 

本研究（PHANTASTIC）将98例骨髓瘤和淋巴瘤患者中一线使用普乐沙福与粒细胞集落刺激因子（G-CSF）的方案，同151例采用传统化疗+G-CSF动员的历史对照患者进行比较。11例患者出现可能与普乐沙福相关的轻度短暂症状，未见严重不良事件。普乐沙福动员组中70例（71%）患者在≤2次单采过程中同时实现CD34+细胞采集量≥4×10^6/kg且无中性粒细胞减少症（<1.0×10^9/L），显著优于传统化疗+G-CSF动员对照组中48例（32%）达到该终点的患者（P<0.001）。普乐沙福组96例（98%）患者在一轮采集期内实现CD34+细胞≥2×10^6/kg，对照组为114例（75%）（P=0.001）。两组患者的植入时间和12个月结局相当。通过两种评分系统总结既往治疗情况：对照组中动员成功（CD34+细胞>2.0或>4.0×10^6/kg）患者的评分显著低于动员失败者（P=0.002），但普乐沙福动员组未观察到该相关性。普乐沙福是比传统化疗更有效、毒性更低的动员剂（尤其在重度预处理患者中），后续结局相当，值得考虑作为干细胞动员的一线标准治疗方案。

原文链接：

Plerixafor is superior to conventional chemotherapy for first-line stem cell mobilisation, and is effective even in heavily pretreated patients