摘要
目的探讨来那度胺对多发性骨髓瘤(MM)患者自体移植造血干细胞采集的影响。方法回顾性分析北部战区总医院血液科2015—2020年采集外周血造血干细胞移植的42例MM患者的临床资料。按照年龄将患者分为年龄≤60岁组(n=24)与年龄>60岁组(n=18)。按照化疗疗程数将患者分为疗程<6次组(n=27)和疗程≥6次组(n=15)。比较两种化疗方案对造血干细胞采集的影响时,选取我院2018—2020年收治的32例MM患者为研究对象,并根据不同方案将其分为来那度胺、硼替佐米及地塞米松(RVD)组(n=10)与硼替佐米、环磷酰胺及地塞米松(BCD)组(n=22)。分析年龄、动员前化疗方案、动员前化疗疗程数与造血干细胞采集间的关系。结果 RVD组患者单个核细胞、CD34+细胞、首次采集成功率均低于BCD组,差异均有统计学意义(P<0.05)。年龄>60岁组患者首次采集CD34+细胞计数低于年龄≤60岁组,差异有统计学意义(P<0.05)。疗程<6次组患者首次采集CD34+细胞计数高于疗程≥6次组,差异有统计学意义(P<0.05)。结论含有来那度胺的化疗方案会损伤造血干细胞,增加造血干细胞采集难度,尤其对于年龄>60岁患者,动员前含有来那度胺的化疗方案应慎用。动员前化疗疗程数应适中,过多的化疗会损害造血干细胞。
Objective To investigate the effect of lenalidomide on hematopoietic stem cell collection for autologous transplantation in patients with multiple myeloma(MM).Methods A retrospective study was performed on 42 cases of patients with MM who were admitted and underwent lenalidomide on hematopoietic stem cell collection for autologous transplantation who were admitted from 2015 to 2020.According to their age,the patients were divided into the group≤60 years old(n=24) and group >60 years old(n=18).According to the number of chemotherapy courses,the patients were divided into two groups:treatment<6 times group(n=27) and treatment≥6 times group(n=15).When comparing the effects of two chemotherapy regimens on hematopoietic stem cell collection,32 MM patients who were admitted from 2018 to 2020 were selected as the research objects,and according to different regimens,patients were divided into linalidomide,bortesomib and dexamethasone(RVD) group(n=10) and bortesomib,cyclophosphamide and dexamethasone(BCD) group(n=22).The relationship between age,chemotherapy regimens before mobilization,the number of chemotherapy courses before mobilization and hematopoietic stem cell collection was analyzed.Results The mononuclear cells,CD34+ cells and the first collection success rate in RVD group were lower than those in BCD group,and the differences were statistically significant(P<0.05).The number of CD34+ cells collected for the first time in the age>60 years group was lower than that in the age≤60 years group(P<0.05).The number of CD34+ cells collected for the first time in the treatment>6 times group was higher than that in the treatment≥6 times group(P<0.05).Conclusion Chemotherapy regimens containing lenalidomide will damage hematopoietic stem cells and increase the difficulty of hematopoietic stem cell collection.Especially for patients aged>60 years,chemotherapy regimens containing lenalidomide before mobilization should be used with caution.The number of chemotherapy courses before mobilization should be moderate.Exce
作者
郭秋霞
王吉刚
刘彦琴
刘景华
张美玉
李敏燕
吴泽来
佟丹江
GUO Qiu-xia;WANG Ji-gang;LIU Yan-qin;LIU Jing-hua;ZHANG Mei-yu;LI Min-yan;WU Ze-lai;TONG Dan-jiang(Department of Hematology,General Hospital of Northern Theater Command,Shenyang 110016,China;Graduate School of Dalian Medical University,Shenyang 116000,China)
出处
《临床军医杂志》
CAS
2021年第1期37-39,43,共4页
Clinical Journal of Medical Officers
基金
辽宁省自然科学基金指导计划(2019-ZD-1031)。
关键词
来那度胺
多发性骨髓瘤
自体移植造血干细胞
Lenalidomide
Multiple myeloma
Autologous transplantation of hematopoietic stem cells
