标准和高剂量G-CSF对患者和健康供者造血祖细胞动员作用的比较

IF 2.7 2区 医学 Q2 HEMATOLOGY Transfusion Medicine Reviews Pub Date : 2022-07-01 DOI:10.1016/j.tmrv.2022.06.004
Irene García-García , Joan Cid , Gloria Carbassé , Javier López-Jiménez , Gemma Moreno , Miquel Lozano
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引用次数: 1

摘要

目前推荐使用标准剂量10µg/kg/天的粒细胞集落刺激因子(g - csf)来动员造血祖细胞(HPCs)。我们的目的是分析某些患者或健康供者是否可以从高剂量G-CSF中获益。我们对患者和健康供者的HPCs动员程序(2015-2020)进行了回顾性多中心分析。接受标准剂量g - csf(患者和健康供者10µg/Kg/天,连续4天)和接受更高剂量(患者24µg/Kg/天,连续4天,健康供者16µg/Kg/天)的组进行比较。共纳入496例(201例为标准剂量,295例为高剂量)。在标准剂量和更高剂量之间,我们没有发现CD34+细胞的中位数/mL有显著差异,健康供者(分别为77 100 vs 75 500, P = 0.895)和患者(分别为34 270 vs 33 704, P = 0.584)之间都没有。此外,在具有相同基础病理的患者中,标准剂量与高剂量之间的比较没有显示差异。在健康供者中,高G-CSF剂量与较低的动员不良发生率(2万个CD34+细胞/mL)无关(1 [1.3%]vs . 0;P = .218)和例(30(24.4%)和32 (18.1%);p = .165)。多因素分析显示,年龄、性别和G-CSF剂量不影响健康供者或患者动员CD34+细胞/mL的中位数。然而,患者的基础病理显著影响CD34+细胞的动员。在健康供者中,G-CSF高剂量组细胞血细胞计数显示白细胞和血小板计数明显升高,而在患者中仅发现血小板计数升高。综上所述,与标准剂量相比,高剂量G-CSF在健康供者或患者中对CD34+细胞的动员方面没有显示出显著的益处,也没有减少动员不良的发生率。
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Comparison Between Standard and High Dose of G-CSF for Mobilization of Hematopoietic Progenitors Cells in Patients and Healthy Donors

A standard dose of 10 µg/kg/day granulocyte colony stimulating factors (G-CSF) is currently recommended for hematopoietic progenitor cells (HPCs) mobilization. Our aim was to analyze whether certain patients or healthy donors could benefit from high dose of G-CSF.We performed a retrospective multicenter analysis of HPCs mobilization procedures (2015-2020) in patients and healthy donors. Those who received standard dose of G-CSF (10 µg/Kg/day for 4 days to patients and healthy donors) and those that received higher dose (24 µg/Kg/day for 4 days to patients and 16 µg/Kg/day for 4 days to healthy donors) were compared.496 individuals were included (201 standard dose and 295 higher dose). Between standard or higher dose, we did not find significant differences in median number of mobilized CD34+ cells/mL, neither among healthy donors (77 100 vs 75 500 respectively, P = .895), nor in patients (34 270 vs 33 704 respectively, P = .584). Additionally, among those with the same underlaying pathology the comparison between standard and higher dose did not showed differences. High G-CSF dose was not associated with a less frequent incidence of poor mobilizers (<20 000 CD34+ cells/mL) neither in healthy donors (1 [1.3%] vs 0; P = .218) nor patients (30 [24.4%] vs 32 [18.1%]; P = .165). Multivariate analysis showed that age, gender, and G-CSF dose did not influence median number of mobilized CD34+ cells/mL in healthy donors or patients. However, the underlying pathology among patients significantly influenced the CD34+ cells mobilization. In healthy donors, cellular blood count showed significantly higher leukocytes and platelets count with G-CSF high-dose, while in patients just a higher platelets count was found. To conclude, high dose of G-CSF compared to standard dose did not show significant benefit in terms of mobilization of CD34+ cells in healthy donors or in patients, also without a decrease in the incidence of poor mobilizers.

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来源期刊
Transfusion Medicine Reviews
Transfusion Medicine Reviews 医学-血液学
CiteScore
11.60
自引率
0.00%
发文量
40
审稿时长
21 days
期刊介绍: Transfusion Medicine Reviews provides an international forum in English for the publication of scholarly work devoted to the various sub-disciplines that comprise Transfusion Medicine including hemostasis and thrombosis and cellular therapies. The scope of the journal encompasses basic science, practical aspects, laboratory developments, clinical indications, and adverse effects.
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