文章：

自体造血干细胞采集中的动员不良相关因素

Poor Mobilization-Associated Factors in Autologous Hematopoietic Stem Cell Harvest

原文发布日期：10 May 2024

DOI: 10.3390/cancers16101821

类型: Article

开放获取: 是

英文摘要：

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,p= 0.008), the use of myelotoxic agents (OR 4.384, 95% CI 2.681–7.168,p< 0.001), and a low platelet count (OR 2.106, 95% CI 1.205–3.682,p= 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,p= 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.

摘要翻译： 

外周血干细胞移植是治疗血液系统疾病和非血液系统疾病的重要治疗手段。为确保移植成功，需要动员并采集足够数量的CD34+细胞。尽管已有研究报道了血液系统疾病患者动员不良的相关风险因素，但针对非血液系统疾病患者及使用普乐沙福患者的研究仍较为有限。为明确动员不良的相关因素，本研究回顾性收集并分析了491例自体外周血干细胞采集患者的数据。多变量分析显示，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）以及血小板计数偏低（OR 2.106，95% CI 1.205–3.682，p=0.009）与动员不良显著相关。在非血液系统疾病患者中，骨盆/脊柱放疗史是唯一相关因素（OR 12.200，95% CI 1.934–76.956，p=0.008）。在使用普乐沙福的患者组中，19例患者出现动员不良（19/134，14.2%），且良好动员组与不良动员组在动员方案上存在差异。这些结果表明，非血液系统疾病患者及使用普乐沙福患者的动员不良风险因素与血液系统疾病患者存在差异；因此，对非血液系统疾病患者需给予特别关注，以确保成功完成外周血干细胞采集。

原文链接：

Poor Mobilization-Associated Factors in Autologous Hematopoietic Stem Cell Harvest