Effectiveness of etoposide chemomobilization in lymphoma patients undergoing auto-SCT.
Effectiveness of etoposide chemomobilization in lymphoma patients undergoing auto-SCT.
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DOI：
10.1038/bmt.2012.216
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发表时间：
2013-06
影响因子：
4.8
通讯作者：
Shea TC
中科院分区：
文献类型：
--
作者：
Wood WA;Whitley J;Goyal R;Brown PM;Sharf A;Irons R;Rao KV;Essenmacher A;Serody JS;Coghill JM;Armistead PM;Sarantopoulos S;Gabriel DA;Shea TC
粒细胞集落刺激因子（G-CSF）在淋巴瘤患者中的干细胞动员效果不佳。我们回顾了我们在159例淋巴瘤患者中使用依托泊苷（VP-16; 375 mg/m2，第+1天和第+2天）和G-CSF（5 ug/kg，每日两次，从第+3天到收集的最后一天）进行化学动员的机构经验。这种方法在94%的患者中成功动员（收集> 2 × 106个CD 34细胞）（在4次单采术中为83%）。57%的患者在≤ 2天内收集了至少5 × 106个细胞，被定义为良好的动员者。该方案是安全的，再住院率低。动员好者的平均成本为14，923美元，动员差者为27，044美元（p<0.05）。使用我们的数据，我们进行了一项“收支平衡”分析，该分析表明，如果良好动员者的频率增加21%，则在首次CD 34计数时向预测的不良动员者添加两剂普乐沙福将实现成本中性，而如果使用三剂普乐沙福，则良好动员者的频率需要增加25%。我们的结论是，化疗动员与依托泊苷和G-CSF的淋巴瘤患者是有效的，未来的机会，成本中性改善使用新的代理商。
The effectiveness of stem cell mobilization with granulocyte colony-stimulating factor (G-CSF) in lymphoma patients is suboptimal. We reviewed our institutional experience using chemomobilization with etoposide (VP-16; 375mg/m2 on days +1 and +2) and G-CSF (5ug/kg twice daily from day +3 through the final day of collection) in 159 patients with lymphoma. This approach resulted in successful mobilization (> 2 × 106 CD34 cells collected) in 94% of patients (83% within 4 apheresis sessions). 57% of patients collected at least 5 × 106 cells in ≤ 2 days and were defined as good mobilizers. The regimen was safe with a low rate of rehospitalization. Average costs were $14,923 for good mobilizers and $27,044 for poor mobilizers (p<0.05). Using our data, we performed a ‘break-even’ analysis that demonstrated that adding two doses of Plerixafor to predicted poor mobilizers at the time of first CD34 count would achieve cost neutrality if the frequency of good mobilizers were to increase by 21%, while the frequency of good mobilizers would need to increase by 25% if three doses of Plerixafor were used. We conclude that chemomobilization with etoposide and G-CSF in patients with lymphoma is effective, with future opportunities for cost-neutral improvement using novel agents.