Objective: To explore the related factors affecting of autologous peripheral hematopoietic stem cell mobilization in patients with single center lymphoma and multiple myeloma.
Methods: The clinical total of 30 patients with lymphoma or multiple myeloma who underwent autologous peripheral hematopoietic stem cell mobilization and transplantation in the Affiliated Hospital of Jiangsu University from March 2012 to December 2021 were retrospectively analyzed, including the patients' age, gender, disease type, chemotherapy course, mobilization scheme, collection times, CD34+ cell count, adverse events, days of neutrophil and platelet implantation after transplantation. The related factors affecting to the mobilization efficiency of peripheral blood stem cells was analyzed.
Results: The mobilization scheme had a significant effect on the mobilization success rate of CD34+ cells. The mobilization success rate and optimal mobilization rate of intermediate-dose VP-16+G-CSF were higher than that of high-dose VP-16+G-CSF (P<0.05); the mobilization success rate of patients with previous chemotherapy courses ≤4 was higher than that of patients with chemotherapy courses >4 (100% vs 72.22%, P<0.05); the mobilization success rate of lymphoma patients was lower than that of myeloma patients (66.67% vs 94.44%, P<0.05); the mobilization success rate of lymphoma patients who received intermediate-dose VP-16+G-CSF was higher than that received high-dose VP-16+G-CSF patients (100% vs 42.86%, P<0.05). Patients' gender, age, time from diagnosis to mobilization and disease status had no significant effect on the efficiency of stem cell mobilization. Fifteen patients (50%) had febrile neutropenia during stem cell mobilization. There was no statistical difference in the incidence of febrile neutropenia between the two mobilization schemes (P>0.05); the incidence of severe thrombocytopenia in intermediate-dose VP-16+G-CSF group was higher than that in high-dose VP-16+G-CSF group (P<0.05). There was no statistical difference in the time of granulocyte implantation and platelet implantation after stem cell transplantation in patients with different mobilization schemes (P>0.05).
Conclusion: Mobilization regime, the number of previous chemotherapy course and disease type affect the mobilization efficiency of stem cells. Intermediate dose VP-16+G-CSF can improve the mobilization efficiency of stem cell in lymphoma patients, but should pay attention to the risk of bleeding.
题目: 淋巴瘤及骨髓瘤患者自体外周造血干细胞动员相关影响因素分析.
目的: 探讨单中心淋巴瘤、多发性骨髓瘤患者自体外周造血干细胞动员相关的影响因素.
方法: 回顾分析2012年3月至2021年12月在江苏大学附属医院行自体外周造血干细胞动员和移植的30例淋巴瘤、多发性骨髓瘤患者的临床资料，包括患者年龄、性别、疾病类型、化疗疗程、动员方案、采集次数、CD34+细胞计数、不良事件、移植后中性粒细胞及血小板植入天数等临床指标，分析造血干细胞动员效率的相关影响因素.
结果: 动员方案中VP-16药物剂量对CD34+细胞动员成功率有显著性影响，中剂量VP-16+G-CSF组动员成功率及优质动员率均高于高剂量VP-16+G-CSF组（P<0.05）；既往化疗疗程数≤4的动员成功率高于化疗疗程数>4（100% vs 72.22%, P<0.05）；淋巴瘤患者动员成功率低于多发性骨髓瘤患者（66.67% vs 94.44%, P<0.05）；淋巴瘤患者接受中剂量VP-16+G-CSF的动员成功率高于高剂量VP-16+G-CSF（100% vs 42.86%, P<0.05）。患者性别、年龄、诊断至干细胞动员的时间、疾病状态等对干细胞动员无显著影响。有15例（50%）患者干细胞动员期间有粒缺伴发热，两种动员方案粒缺期发热发生率差异无统计学意义（P>0.05）；中剂量VP-16+G-CSF组严重血小板减少发生率高于高剂量VP-16+G-CSF组（P<0.05）。不同动员方案的患者干细胞移植后粒细胞植入时间及血小板植入时间差异无统计学意义（P>0.05）.
结论: 动员方案中VP-16剂量、既往化疗疗程数、疾病类型影响干细胞动员效率；中剂量VP-16+G-CSF能提高淋巴瘤患者干细胞动员效率，但需注意出血风险.
Keywords: autologous hematopoietic stem cell transplantation; etoposide; mobilization; peripheral blood stem cells.