普乐沙福联合粒细胞集落刺激因子在淋巴瘤患者中进行自体造血干细胞动员的效果及安全性

OBJECTIVE: To evaluate the advantages and safety of Plerixafor in combination with granulocyte colony-stimulating factor（G-CSF）in autologous hematopoietic stem cell mobilization of lymphoma. METHODS: Lymphoma patients who received autologous hematopoietic stem cell mobilization with Plerixafor in combination with G-CSF or G-CSF alone were obtained. The clinical data, the success rate of stem cell collection, hematopoietic reconstitution, and treatment-related adverse reactions between the two groups were evaluated retrospectively. RESULTS: A total of 184 lymphoma patients were included in this analysis, including 115 cases of diffuse large B-cell lymphoma（62.5％）, 16 cases of classical Hodgkin's lymphoma（8.7％）, 11 cases of follicular non-Hodgkin's lymphoma（6.0％）, 10 cases of angioimmunoblastic T-cell lymphoma（5.4％）, 6 cases of mantle cell lymphoma（3.3％）, and 6 cases of anaplastic large cell lymphoma（3.3％）, 6 cases of NK/T-cell lymphoma（3.3％）, 4 cases of Burkitt's lymphoma（2.2％）, 8 cases of other types of B-cell lymphoma（4.3％）, and 2 cases of other types of T-cell lymphoma（1.1％）; 31 patients had received radiotherapy（16.8％）. The patients in the two groups were recruited with Plerixafor in combination with G-CSF or G-CSF alone. The baseline clinical characteristics of the two groups were basically similar. The patients in the Plerixafor in combination with the G-CSF mobilization group were older, and the number of recurrences and third-line chemotherapy was higher. 100 patients were mobilized with G-CSF alone. The success rate of the collection was 74.0％ for one day and 89.0％ for two days. 84 patients in the group of Plerixafor combined with G-CSF were recruited successfully with 85.7％ for one day and 97.6％ for two days. The success rate of mobilization in the group of Plerixafor combined with G-CSF was substantially higher than that in the group of G-CSF alone（P＝0.023）. The median number of CD34(+) cells obtained in the mobilization group of Plerixafor combined with G-CSF was 3.9×10(6)/kg. The median number of CD34(+) cells obtained in the G-CSF Mobilization group alone was 3.2×10(6)/kg. The number of CD34(+) cells collected by Plerixafor combined with G-CSF was considerably higher than that in G-CSF alone（P＝0.001）. The prevalent adverse reactions in the group of Plerixafor combined with G-CSF were grade 1–2 gastrointestinal reactions（31.2％）and local skin redness（2.4％）. CONCLUSION: The success rate of autologous hematopoietic stem cell mobilization in lymphoma patients treated with Plerixafor combined with G-CSF is significantly high. The success rate of collection and the absolute count of CD34(+) stem cells were substantially higher than those in the group treated with G-CSF alone. Even in older patients, second-line collection, recurrence, or multiple chemotherapies, the combined mobilization method also has a high success rate of mobilization.