造血干细胞动员不佳的4例儿童患者应用普乐沙福经验分享

Experience sharing of using plerixafor in four children with poor hematopoietic stem cells mobilization

目的分析造血干细胞动员不佳儿童应用普乐沙福的疗效和安全性。方法回顾性分析4例造血干细胞动员不佳儿童应用普乐沙福的动员效果和安全性,并结合相关文献复习。结果4例患儿均为男性,中位年龄为7.5(2~10)岁,诊断松果体混合型生殖细胞瘤1例,髓母细胞瘤1例,神经母细胞瘤2例。4例患儿既往动员效果不佳,3例患儿在使用普乐沙福后CD34+细胞采集量>2.0×10^(6)/kg,中位CD34+细胞采集量为2.54(1.41~4.01)×10^(6)/kg,中位采集天数为1.5(1~2)d,无不良反应。使用普乐沙福前后外周血CD34+细胞中位数分别为11.5cells/μL和28.2cells/μL,中位增长倍数为2.8。4例患儿均进行自体造血干细胞移植治疗,白细胞和血小板的中位植入中位时间分别为12d和16.5d。结论普乐沙福对于造血干细胞动员不佳的儿童患者具有显著的疗效且安全性良好。

Objective To evaluate the efficacy and safety of plerixafor in children with poor hematopoietic stem cell mobilization.Methods The mobilization effect and safety of plerixafor in 4 pediatric patients with poor hematopoietic stem cell mobilization were analyzed retrospectively,and relevant literature were reviewed.Results All 4 patients were male with a median age of 7.5(2-10)years old,including 1 pineal mixed germinoma,1 medulloblastoma,and 2 neuroblastoma.All patients were poor hematopoietic stem cell mobilizer.4 patients underwent apheresis and in 3 cases,>2×10^(6) CD34+cells per kg of body weight were collected after using plerixafor.The median amount of CD34+cells was 2.54(1.41-4.01)×10^(6)/kg.The median number of apheresis days was 1.5(1-2)days,and there were no adverse reactions.The number of CD34+cells in peripheral blood before and after using plerixafor is 11.5 cells/μL and 28.2cells/μL.The CD34+cells in peripheral blood after using plerixafor increased a median 2.8-fold than before.All patients subsequently underwent autologous hematopoietic stem cell transplantation.The median time of neutrophil and platelet recovery was12days and 16.5 days.Conclusions Plerixafor has significant efficacy and safety for children with poor hematopoietic stem cell mobilization.