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/m2) 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;p= 0.199). The yield of collected CD34+ cells did not differ between the different cytarabine doses (p= 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/m2) seem to be preferable.
挽救性自体造血细胞移植可用于治疗既往自体移植后复发的浆细胞骨髓瘤。当初始采集储存的造血干细胞数量不足时，需进行再动员。本研究旨在分析不同剂量阿糖胞苷（总量800 vs. 1600 vs. 2400 mg/m²）用于再动员的有效性和安全性。共纳入65例患者，男性占55%，再动员中位年龄63岁。其中7例接受阿糖胞苷_800方案，36例接受阿糖胞苷_1600方案，22例接受阿糖胞苷_2400方案。接受阿糖胞苷_1600方案的患者中25%使用普乐沙福补救，阿糖胞苷_2400组为27%，阿糖胞苷_800组未使用普乐沙福补救。总体再动员成功率为80%（阿糖胞苷_800组57%；阿糖胞苷_1600组86%；阿糖胞苷_2400组77%；p=0.199）。不同剂量组采集的CD34+细胞数量无统计学差异（p=0.495）。阿糖胞苷_2400组患者发生严重血细胞减少、需要血液制品支持或血流感染的风险最高。1例患者在阿糖胞苷_2400治疗后死于感染性休克。综上所述，阿糖胞苷再动员对多数患者可行，各剂量方案均能实现成功再动员。阿糖胞苷_2400方案毒性较高，因此较低剂量（800或1600 mg/m²）方案更具优势。
肿瘤(癌症)患者之家