实体瘤自体造血干细胞动员不佳患儿应用普乐沙福的经验分享

Experience sharing of plerixafor in children with poor mobilization of hematopoietic stem cells in solid tumors

目的 分析普乐沙福对实体瘤自体造血干细胞动员不佳患儿的作用及安全性。方法 回顾性分析5例实体瘤造血干细胞动员不佳患儿的临床资料,所有患儿均应用普乐沙福自体造血干细胞动员,分析干细胞动员血象变化、采集结果及不良反应发生情况。结果 外周血(PB) CD34^(+)细胞计数<10 cells/μl及第1天采集物CD34^(+)细胞计数<1.5×10^(6)/kg时及时加用普乐沙福;加用普乐沙福后1例采集1次,1例采集2次,3例采集3次。5例患儿中3例采集成功。未出现乏力、失眠、腹痛、腹泻、头晕、关节痛等不良反应。3例患儿已行自体干细胞移植,粒细胞及血小板均植入。结论 外周血CD34^(+)细胞计数<10 cells/μl及第1天采集物CD34^(+)细胞计数<1.5×10^(6)/kg时加用普乐沙福获得采集成功普乐沙福用于实体瘤动员不佳患儿自体造血干细胞动员,不良反应少,耐受性好。

Objective To analyze the role and safety of plerixafor in children with poor mobilization of hematopoietic stem cells in solid tumors.Methods The clinical data of 5 children with poor mobilization of hematopoietic stem cells in solid tumors were retrospectively analyzed,and all children were applied with plerixafor for autologous hematopoietic stem cell mobilization to analyze the changes of blood picture of stem cell mobilization,collection results and the occurrence of adverse effects.Results Plerixafor was timely added if peripheral blood(PB)CD34^(+) cell count+<10 cells/μl and amount of collection of CD34^(+)<1.5×10^(6)/kg in first day;after the combination use of plerixafor,1 case was collected for once,1 case was collected for twice,and 3 cases were collected for three times.Peripheral hematopoietic stem cells were successfully collected in 3 of 5 patients.There were no adverse reactions such as fatigue,insomnia,abdominal pain,diarrhea,dizziness and joint pain.Autologous stem cell transplantation was performed in 3 patients,and both granulocytes and platelets were implanted.Conclusion In case of peripheral blood CD34^(+)cell count+<10 cells/μl and amount of collection of CD34^(+)<1.5×10^(6)/kg in first day,peripheral stem cells are successfully collected when plerixafor is applied.Plerixafor in children with poor mobilization of hematopoietic stem cells in solid tumors has less adverse reactions and good tolerance.