Objective: To evaluate the efficacy of applying mecapegfilgrastim for peripheral blood hematopoietic stem cell (PBSC) mobilization in patients with hematologic neoplasms, and to investigate the influencing factors of PBSC collection.
Methods: Patients who underwent PBSC mobilization in the Department of Hematology, Mianyang Central Hospital between April 2016 and May 2022 were retrospectively analyzed. The CD34 + cell collection results of two groups, the mecapegfilgrastim group ( n=28), or the PEG group, and the recombinant human granulocyte colony-stimulating factor (rhG-CSF) group ( n=30), were compared, and the influencing factors of collection failure were analyzed.
Results: The success rates of CD34 + cells collection in the PEG group and the rhG-CSF group were 75.0% and 63.3%, respectively ( P>0.05). The median CD34 + cell counts were 3.37×10 6/kg and 2.68×10 6/kg, respectively, showing no significant difference. After combined mobilization with plerixafor, the median counts of CD34 + cells collected in the PEG group and rhG-CSF group were 4.23×10 6/kg and 3.26×10 6/kg, respectively, showing no significant difference ( P>0.05). There was no significant difference in hematopoietic system reconstruction and infections between the two groups ( P>0.05). Multivariate analysis found non-plasma cell disease (odds ratio [ OR]=19.697, 95% confidence interval [ CI] : 1.501-258.537, P=0.023), anemia before collection ( OR=18.571, 95% CI: 1.354-254.775, P=0.029) and white blood cell count before collection under 32×10 9 L -1 ( OR=85.903, 95% CI: 4.947-1491.807, P=0.002) to be independent risk factors for PBSC collection failure.
Conclusion: The effect of PBSC mobilization with mecapegfilgrastim was comparable to that of rhG-CSF in patients with hematologic neoplasms. Furthermore, combined mobilization with plerixafor was feasible and effective. Patients with leukemia or lymphoma, anemia, and WBC<32×10 9 L -1 before stem cell collection have a high probability of PBSC collection failure.
目的: 评估硫培非格司亭用于血液肿瘤患者外周血造血干细胞（peripheral blood hematopoietic stem cell, PBSC）动员的效果，探讨PBSC采集的影响因素。
方法: 回顾性分析2016年4月–2022年5月在绵阳市中心医院血液科行PBSC动员的病例，比较含硫培非格司亭（硫培组，28例）和含重组人粒细胞集落刺激因子（recombinant human granulocyte colony-stimulating factor, rhG-CSF）（rhG-CSF组，30例 ）两组的CD34+细胞采集成功率，并分析采集失败的影响因素。
结果: 硫培组和rhG-CSF组CD34+细胞采集成功率分别为75.0%和63.3%，CD34+细胞采集中位值分别为3.37×106/kg和2.68×106/kg，差异均无统计学意义。经普乐沙福补救的硫培组和rhG-CSF组CD34+细胞采集中位值分别为4.23×106/kg和3.26×106/kg，差异无统计学意义。两组在造血系统重建和感染等方面也无明显差异（P>0.05）。多因素分析发现非浆细胞疾病〔比值比（odds ratio, OR）=19.697，95%置信区间（confidence interval, CI）：1.501～258.537，P=0.023〕、采集前贫血（OR=18.571，95%CI：1.354～254.775，P=0.029）、采集前WBC<32×109 L−1（OR=85.903，95%CI：4.947～1491.807，P=0.002）是PBSC采集失败的独立危险因素。
结论: 硫培非格司亭在血液肿瘤患者中的PBSC动员效果与rhG-CSF相当，且联合普乐沙福动员可行、有效。白血病和淋巴瘤、采集干细胞前贫血及WBC<32×109 L−1的患者PBSC采集失败的可能性大。
Keywords: Hematologic neoplasms; Hematopoietic stem cell mobilization; Mecapegfilgrastim; Recombinant human granulocyte colony-stimulating factor; Root cause analysis.
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