多发性骨髓瘤患者外周血CD34阳性细胞计数对普乐沙福干细胞动员效果的预测价值

Predictive value of peripheral blood CD34-positive cell count for the stem cell mobilization effect of plerixafor in patients with multiple myeloma

目的探讨多发性骨髓瘤(MM)患者外周血CD34阳性细胞计数对普乐沙福干细胞动员效果的预测价值。方法回顾性分析2019年12月至2021年2月广西医科大学第一附属医院使用普乐沙福进行干细胞动员的12例MM患者临床资料。分析普乐沙福动员前后外周血CD34阳性细胞计数的变化及干细胞采集情况。结果共有12例患者纳入研究,国际分期系统(ISS)分期Ⅱ~Ⅲ期,诱导方案以VRD为主。不论在普乐沙福前用何种方案进行干细胞动员,患者在使用普乐沙福后CD34阳性细胞计数均升高,使用普乐沙福前后中位CD34阳性细胞计数分别为3.63/μl(0.72~13.53/μl)和32.11/μl(8.52~53.68/μl),差异有统计学意义(Z=-0.40,P<0.001),中位升高倍数为11.50倍(1.61~23.71倍)。12例患者中有1例动员失败,该患者在使用普乐沙福前外周血CD34阳性细胞计数<1/μl,使用普乐沙福后CD34阳性细胞计数虽然提高了11.83倍,但仍<10/μl。Pearson相关分析结果显示,在使用普乐沙福前CD34阳性细胞计数<4/μl的患者中,使用普乐沙福前后CD34阳性细胞计数呈正相关(r=0.80,P=0.032)。结论MM患者外周血CD34阳性细胞计数对普乐沙福干细胞动员效果有一定的预测价值。

Objective To explore the predictive value of peripheral blood CD34-positive cell count for the stem cell mobilization effect of plerixafor in patients with multiple myeloma(MM).Methods The clinical data of 12 MM patients who used plerixafor for stem cell mobilization in the First Affiliated Hospital of Guangxi Medical University from December 2019 to February 2021 were retrospectively analyzed.The changes of peripheral blood CD34-positive cell count and the collection status of stem cell in all patients before and after the mobilization of plerixafor were analyzed.Results Twelve patients were included in this study.These patients were in international staging system(ISS)stageⅡ-Ⅲ,and the induction therapy was mainly VRD regimen.The CD34-positive cell count was increased after the use of plerixafor in all patients no matter which mobilization strategies were used before plerixafor.The CD34-positive cell count was 3.63/μl(0.72-13.53/μl)and 32.11/μl(8.52-53.68/μl)before and after the use of plerixafor,and the difference was statistically significant(Z=-0.40,P<0.001);the median increasing time was 11.50 times(1.61-23.71 times).The mobilization failure occurred in 1 patient.The CD34-positive cell count in his blood was less than 1/μl before the use of plerixafor;though increased 11.83 times after the use of plerixafor,the CD34-positive cell count was still less than 10/μl.Pearson analysis showed that among the patients with CD34-positive cell count less than 4/μl before the use of plerixafor,there was a positive correlation in peripheral blood CD34-positive cell count before and after the use of plerixafor(r=0.80,P=0.032).Conclusions The peripheral blood CD34-positive cell count has a certain predictive value for the stem cell mobilization effect of plerixafor in MM patients.