A risk-based approach to optimize autologous hematopoietic stem cell (HSC) collection with the use of plerixafor
A risk-based approach to optimize autologous hematopoietic stem cell (HSC) collection with the use of plerixafor
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DOI：
10.1038/bmt.2011.133
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发表时间：
2012-04-01
影响因子：
4.8
通讯作者：
McGuirk, J.
中科院分区：
文献类型：
--
作者：
Abhyankar, S.;DeJarnette, S.;McGuirk, J.
自体造血干细胞（HSC）移植是治疗恶性血液病的有效方法。不幸的是，15-30%的患者无法动员足够数量的造血干细胞进行移植。Plerixafor现在被用作打捞动员方案，取得了良好的成功。我们在这里描述了一种基于风险的使用plerixafor的方法，基于循环CD34（+）细胞计数和G-CSF 4天后收集的CD34（+）细胞剂量，可以预先识别潜在的不良HSC动员剂。共有159例患者采用这种方法采集了HSC。其中55例（35%）在收集的第1天由于CD34（+）细胞数量低或产量低而被确定为高风险，并在随后的收集天接受了plerixafor。在159名患者中，151名（95%）患者能够在使用该方法的中位时间为1.7天的第一次动员尝试中提供足够的收集。在8例首次动员失败的患者中，5例成功地使用plerixafor和G-CSF再次动员，3例（1.9%）动员失败。这种方法有助于控制我们BMT项目的HSC采集的总体成本，减少了再移动的需要，减少了采集天数，避免了所有患者使用plerixafor。骨髓移植（2012）47,483-487；doi: 10.1038 / bmt.2011.133;2011年7月4日在线发布
Autologous hematopoietic stem cell (HSC) transplant is an effective treatment for patients with hematological malignancies. Unfortunately, 15-30% of patients fail to mobilize a sufficient number of HSCs for the transplant. Plerixafor is now used as a salvage mobilization regimen, with good success. We describe here a risk-based approach for the use of plerixafor, based on the circulating CD34(+) cell count and the CD34(+) cell dose collected after 4 days of G-CSF, that identifies potential poor HSC mobilizers upfront. A total of 159 patients underwent HSC collections using this approach. Of these, 55 (35%) were identified as high risk owing to low CD34(+) cell number or low yield on day 1 of collection, and received plerixafor on the subsequent days of collection. Of the 159 patients, 151 (95%) were able to provide adequate collections with the first mobilization attempt in a median of 1.7 days using this approach. Of the eight who failed initial mobilization, 5 successfully underwent re-mobilization with plerixafor and G-CSF and 3 (1.9%) were mobilization failures. This approach helped to control the overall cost of HSC collections for our BMT program by decreasing the need for remobilization, reducing the number of collection days and avoiding the use of plerixafor in all patients. Bone Marrow Transplantation (2012) 47, 483-487; doi:10.1038/bmt.2011.133; published online 4 July 2011