广州医药 ›› 2023, Vol. 54 ›› Issue (12): 72-77.DOI: 10.3969/j.issn.1000-8535.2023.12.012

• 论著 • 上一篇    下一篇

监测外周血CD34+细胞计数预测普乐沙福联合G-CSF自体干细胞动员的效果

刘芳洁, 宾婷, 谢媚, 解荣丽, 王小博   

  1. 中山大学附属第七医院血液内科(广东深圳 518107)
  • 收稿日期:2023-08-09 出版日期:2023-12-20 发布日期:2024-01-10
  • 通讯作者: 王小博,E-mail:wangxiaobo@sysush.com
  • 基金资助:
    广东省自然科学基金联合基金-青年项目(2019A151510703)

Predictive effect of monitoring peripheral blood CD34+ cell count on autologous stem cell mobilization with plerixafor

LIU Fangjie, BIN Ting, XIE Mei, XIE Rongli, WANG Xiaobo   

  1. Department of Hematology,the Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen 518107,China
  • Received:2023-08-09 Online:2023-12-20 Published:2024-01-10

摘要: 目的 探讨外周血CD34阳性(CD34+)细胞计数对普乐沙福自体干细胞动员效果的预测价值。方法 回顾性分析2021年5月—2023年7月中山大学附属第七医院使用人粒细胞集落刺激因子(G-CSF)联合普乐沙福进行自体干细胞动员的13例患者临床资料,分析普乐沙福动员前后外周血CD34+细胞计数的变化及干细胞采集情况。结果 共有13例患者纳入研究,包括淋巴瘤10例和多发性骨髓瘤3例。多发性骨髓瘤患者中1例为新诊断,另2例为复发患者;淋巴瘤患者中3例为套细胞淋巴瘤,6例为弥漫大B细胞淋巴瘤(包括1例复发),1例为B细胞淋巴瘤(不能明确类型)。本研究纳入的患者均使用G-CSF动员,在使用普乐沙福后CD34+细胞计数均升高,使用普乐沙福前中位CD34+细胞计数为13.3(2.5~76.1)/μL,使用普乐沙福后中位CD34+细胞计数为73.6(10.4~208.70)/μL,升高4.18(1.99~13.60)倍。13例患者中有2例患者在使用普乐沙福前外周血CD34+细胞计数<5 /μL,均动员失败。Spearman相关分析结果显示,使用普乐沙福后CD34+细胞计数与使用普乐沙福前CD34+细胞数呈正相关(rs=0.769,P=0.003)。多元线性回归分析显示,使用普乐沙福后CD34+细胞计数能较好地预测采集结果(P=0.004)。结论 监测外周血CD34+细胞计数可预测普乐沙福自体干细胞动员效果,使用普乐沙福后CD34+细胞计数越多,CD34+细胞采集量越大。

关键词: 造血干细胞, 动员, 普乐沙福, CD34+细胞计数

Abstract: Objective To explore the predictive value of peripheral blood CD34+ cell count for the stem cell mobilization effect of plerixafor.Methods The clinical data of 13 patients who used granulocyte colony-stimulating factor + plerixafor for stem cell mobilization in the Seventh Affiliated Hospital of Sun Yat-sen University from May 2021 to July 2023 were retrospectively analyzed.The changes of peripheral blood CD34+ cell count in all patients before and after the mobilization of plerixafor were analyzed.Results In 13 enrolled patients,there were 10 lymphoma patients and 3 multiple myeloma(MM)patients.One patient was newly diagnosed with MM,and the other two were recurrent patients.The lymphoma cases included 3 mantle cell lymphoma,6 diffuse large B cell lymphoma and 1 B cell non-Hodgkin's lymphoma(type cannot be specified).The CD34+ cell counts were increased in all patients when mobilized with granulocyte colony-stimulating factor before plerixafor.The CD34+ cell count was 13.3(2.5~76.1)/μL and 73.6(10.4~208.70)/μL before and after the use of plerixafor,between which the difference was statistically significant(Z=0.578,P<0.05),and the median increased of 4.18(1.99~13.6)times.There were 2 patients failed in mobilizing whose CD34+ cell count was less than 5 /μL before using plerixafor.Spearman analysis showed that there was a positive correlation in peripheral blood CD34+ cell count before and after the use of plerixafor(rs=0.80,P=0.032).The CD34+ cell count after using plerixafor was a good predictor of the collection results(P=0.002).Conclusions Monitoring the CD34+ cell count in peripheral blood has a certain predictive value for the stem cell mobilization effect of plerixafor.The higher of CD34+ cell count after the use of plerixafor,the higher of CD34+ collection.

Key words: hematopoietic stem cell, mobilization, plerixafor, CD34+ cell count