期刊文献+

149例多发性骨髓瘤患者自体外周血造血干细胞动员采集的回顾性分析 被引量:2

A retrospective analysis of autologous peripheral blood hematopoietic stem cell mobilizations and collections in 149 multiple myeloma patients
分享 导出
摘要 目的 了解多发性骨髓瘤(MM)患者自体外周血造血干细胞动员采集的状况及影响因素.方法 回顾分析1998年1月至2014年3月149例MM患者采用环磷酰胺(CTX)或E-CHOP(依托泊苷+CTX+表阿霉素+长春地辛+泼尼松)化疗联合G-CSF动员采集外周血造血干细胞的资料[采集获得CD34^+细胞数、成功(获得的CD34^+细胞数≥2×10^6/kg)率、优良(获得的CD34^+细胞数≥5×10^6/kg)率].分析性别、年龄、疾病类型、DS分期、ISS分期、动员前治疗情况、动员时疾病状态、动员方案等因素与采集结果之间的关系.结果 149例患者共进行了177例次动员采集,采集CD34^+细胞中位数为3.20(0.13~22.34)×10^6/kg,采集成功率、优良率分别为74.5%、27.5%.单因素分析显示:性别、年龄(>60岁/≤60岁)、疾病类型、DS分期(Ⅲ/Ⅰ+Ⅱ)、ISS分期(Ⅲ/Ⅰ+Ⅱ)及动员方案(E-CHOP+G-CSF/CTX+G-CSF)与采集获得CD34^+细胞数、采集成功率无相关性(P>0.05),但>60岁的患者单次采集成功率较低(P<0.05),DSⅢ期的患者采集优良率较低(P.<0.05);动员前疗程数≤6、动员时疾病状态为部分缓解及以上的患者采集效果较好.动员前治疗情况影响干细胞采集成功率(P=0.006),疗程数>6的患者干细胞采集失败风险高(OR值为3.57,95% CI 1.45~8.78).结论 性别、年龄、诊断类型、DS分期、ISS分期、动员采用的化疗方案对MM患者外周血干细胞采集成功率无影响,但年龄较大的患者需要两次动员.动员前疗程数较少、动员时相对稳定的疾病状态有利于造血干细胞的动员采集. Objective To analyze the results and influential factors of mobilization and harvesting of autologous peripheral blood stem cell in patients with multiple myeloma (MM).Methods Retrospective analysis of peripheral blood stem cell collection data [CD34^+ cells collected,successful mobilization rate (CD34^+ cells≥2 × 10^6/kg body weight),good mobilization rate (CD34^+ cells≥5 × 10^6/kg body weight)] of 149 multiple myeloma patients who were treated with cyclophosphamide (CTX) or E-CHOP (etoposide+ CTX+epirubicin+vindesine+prednisone) chemotherapy combined with G-CSF mobilization from January 1998 to March 2014.The relevance between gender,age,subtype,DS staging,ISS staging,treatment before mobilization,disease status at mobilization,regiment of mobilizationand the collection results was analyzed.Results A total of 177 stem cell mobilizations were performed in 149 MM patients,the median CD34^+ cells harvested were 3.20 (0.13-22.34)× 10^6/kg body weight (BW),successful mobilization rate and good mobilization rate were 74.5% and 27.5%,respectively.The single logistic regression analysis showed that gender,age (〉 60 ys vs ≤60 ys),subtype,DS staging (Ⅲ vs Ⅱ + Ⅰ),ISS staging (Ⅲ vs Ⅱ + Ⅰ) and regiment of mobilization (E-CHOP+G-CSF vs ID-CTX+G-CSF) were not correlated with the cell collection or successful mobilization rate (P〉0.05).However,successful collection rate of single harvest in old patients (age〉60 ys) was lower (P〈0.05),andthe good mobilization rate in patients at ISS stage Ⅲ was lower (P 〈 0.05).The collection results of patients with fewer cycles of treatment (treatment before mobilization ≤6 cycles) and optimal disease status (disease status at mobilization ≥partial remission) were much better.Analysis of logistic factors revealed that treatment efficacy before mobilization affected success rate of collection (P=0.006).Risk of collection failure in patients who received more than
作者 王国蓉 陈文明 李燕郴 高文 杨光忠 李欣 刘晋伟 杨变红 Wang Guorong, Chen Wenming, Li Yanchen, Gao Wen, Yang Guangzhong, Li Xin, Liu Jinwei, Yang Bianhong.( Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China)
出处 《中华血液学杂志》 CAS CSCD 北大核心 2015年第5期367-371,共5页 Chinese Journal of Hematology
基金 首都临床特色应用研究(Z131107002213146)
关键词 多发性骨髓瘤 造血干细胞动员 移植 自体 Multiple myeloma Hematopoietic stem cell mobilization Transplantation,autologous
作者简介 通信作者:陈文明,Email:wenming_chen@yahoo.com
  • 相关文献

参考文献13

  • 1Rajkumar SV. Treatment of multiple myeloma [J]. Nat Rev Clin Oncol, 2011, 8(8):479-491. 被引量:1
  • 2Kyle RA, Rajkumar SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma [J]. Leukemia, 2009, 23 ( 1 ):3-9. 被引量:1
  • 3Greipp PR, San Mignel J, Durie BG, et al. International staging system for multiple myeloma [J]. J Clin Oncol, 2005, 23 (15): 3412-3420. 被引量:1
  • 4Wuchter P, Ran D, Bruckner T, et al. Poor mobilization of hematopoietic stem cells-definitions, incidence, risk factors, and impact on outcome of antologous transplantation[J]. Biol Blood Marrow Transplant, 2010, 16(4):490-499. 被引量:1
  • 5Bensinger W, Appelbaum F, Rowley S, et al. Factors that influence collection and engraftment of autologous peripheral- blood stem cells[J]. J Clin Oncol, 1995, 13( 10):2547-2555. 被引量:1
  • 6Stiff P J, Micallef I, Nademanee AP, et al. Transplanted CD34 (+) cell dose is associated with long-term platelet count recov- ery following autologous peripheral blood stem cell transplant in patients with non-Hodgkin lymphoma or multiple myeloma [J]. Biol Blood Marrow Transplant, 2011, 17 ( 8 ): 1146-1153. 被引量:1
  • 7Duong HK, Savani BN, Copelan E, et al. Peripheral blood progenitor cell mobilization for autologous and allogeneic hematopoietic cell transplantation: guidelines from the American Society for Blood and Marrow Transplantation [J]. Biol Blood Marrow Transplant, 2014, 20(9): 1262-1273. 被引量:1
  • 8Cavo M, Rajkumar SV, Palumbo A, et al. International Myeloma Working Group consensus approach to the treatment of multiple myeloma patients who are candidates for autologous stem cell transplantation[J]. Blood, 2011, 117(23):6063-6073. 被引量:1
  • 9Olivieri A, Marchetti M, Lemoli R, et al. Proposed definition of 'poor mobilizer' in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo ItalianoTrapianto di Midollo Osseo [J]. Bone Marrow Transplant, 2012, 47(3):342-351. 被引量:1
  • 10Gertz MA, Wolf RC, Micallef IN, et al. Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma [J]. Bone Marrow Transplant, 2010, 45(9): 1396-1403. 被引量:1

同被引文献2

引证文献2

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈