普乐沙福联合G-CSF在浆细胞疾病自体造血干细胞动员中的有效性及安全性

OBJECTIVE: To analyze the effect and safety of plerixafor combined with G-CSF mobilization in plasma cell disease. METHODS: The clinical baseline data, success rate of collection, and adverse reactions of consecutive cases of plasma cell disease were analyzed retrospectively, where the patients received plerixafor combined with G-CSF for autologous hematopoietic stem cell mobilization in Peking University People's Hospital from January 2018 to December 2019. RESULTS: Forty-nine patients with plasma disease were included, of which 39 (79.6%) were multiple myeloma, 8 (16.3%) were amyloidosis, and 2 (4.1%) were monoclonal gammopathy of renal significance. A total of 16 patients (32.7%) had renal insufficiency, and 7 patients (14.3%) had previous collection failure. The median times of apheresis was 1 (1–3), median days of apheresis was 2 (1–3) days, 47 patients (95.9%) were successfully collected for once, and the success rate of collection for twice was 100% after using plerixafor for mobilization. In 16 patients with renal insufficiency, collection was successful in 5 patients (31.3%) on the first day, while aphresis was required in 8 patients (50%) on the second day and 3 (18.8%) on the third day. The main adverse reactions were fatigue, insomnia, abdominal pain, diarrhea, dizziness, and arthralgia. A total of 37 patients underwent autologous hematopoietic stem cell transplantation with 11 (8–13) days for neutrophil engraftment, and 11 (9–26) days for platelet engraftment. CONCLUSION: Plerixafor combined with G-CSF has a high success rate in mobilizaion of autologous hematopoietic stem cells in patients with plasma cell disease with minimum side effects, even in patients with renal insufficiency.