PBSC mobilization in newly diagnosed patients with POEMS syndrome: outcomes and prognostic factors
PBSC mobilization in newly diagnosed patients with POEMS syndrome: outcomes and prognostic factors
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新诊断 POEMS 综合征患者的 PBSC 动员：结果和预后因素
DOI：
10.1038/bmt.2012.138
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发表时间：
2013
影响因子：
4.8
通讯作者：
D. Zhou
中科院分区：
文献类型：
--
作者：
Jian Li;Wei Zhang;Minghui Duan;L. Jiao;Tienan Zhu;Bing Han;Lu Zhang;J. Gan;D. Zhou
自体PBSC移植是多发性神经病、器官肿大、内分泌病、M蛋白和皮肤变化（POEMS综合征）患者的首选治疗方法。然而，关于POEMS综合征中干细胞动员的数据有限。我们回顾性分析了新诊断的POEMS综合征患者的活动结果和预后因素。共纳入56例患者（41例男性和15例女性），中位年龄为45岁（范围：24-62岁）。所有患者均接受了CY+粒细胞CSF（G-CSF）（n=38）或G-CSF单独（n=18）动员。收获的CD 34+细胞总数中位值为2.01 × 106/kg（范围：0.18-9.0 × 106/kg）。29例（51.8%）患者的CD 34+细胞数低于2 × 106/kg，其中7例（12.5%）患者的CD 34+细胞数低于1 × 106/kg。总的动员相关的发病率为23.3%，急性肾功能衰竭是最常见的并发症在动员。多因素分析显示，肝肿大（OR 0.06，95% CI 0.01-0.43）和G-CSF动员方案（OR 0.08，95% CI 0.01-0.70）是POEMS综合征动员成功的独立预后因素。总之，新诊断的POEMS综合征患者的动员具有挑战性，CD 34+细胞产量低，发病率高。动员前的诱导治疗可提高动员的有效性和安全性。
Autologous PBSC transplantation is a preferred treatment for patients with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS syndrome). However, data on stem cell mobilization in POEMS syndrome are limited. We retrospectively reviewed outcomes and factors prognostic of mobilization in newly diagnosed patients with POEMS syndrome. A total of 56 patients (41 men and 15 women) were included and the median age was 45 years (range, 24–62). All patients underwent mobilization with CY plus granulocyte CSF (G-CSF) (n=38) or G-CSF alone (n=18). The median total number of harvested CD34+ cells was 2.01 × 106/kg (range, 0.18–9.0 × 106/kg). In all, 29 (51.8%) patients failed to yield more than 2 × 106/kg CD34+ cells, and among them, 7 (12.5%) patients yielded <1 × 106/kg CD34+ cells. The overall mobilization-related morbidity was 23.3% and acute renal failure was the most common complication during mobilization. Multivariate analysis showed that hepatomegaly (odds ratio 0.06, 95% confidence interval (CI) 0.01–0.43) and mobilization regimen of G-CSF alone (odds ratio 0.08, 95% CI 0.01–0.70) were independent prognostic factors for successful mobilization in POEMS syndrome. In conclusion, mobilization in newly diagnosed patients with POEMS syndrome is challenging with low yield of CD34+ cells and high morbidity. Induction therapy before mobilization might improve the efficacy and safety of mobilization.
影响因子：
20.3
作者：
Dispenzieri, A;Kyle, RA;Gertz, MA
通讯作者：
Gertz, MA