四重诱导疗法对干细胞调动产量的影响,新诊断的多发性骨髓瘤
Ryan Beechinor1, Stepfanie Lam2, Aaron Steele2
1Department of Pharmacy, University of California Davis Medical Center, Sacramento, CA, USA; Department of Clinical Pharmacy, School of Pharmacy, University of California, SanFrancisco, CA, USA. Electronic address: https://twitter.com/RBeechPharmD.
概括
对多发性骨髓瘤的达拉图马布四重诱导不会影响初始干细胞采集的成功. 然而,它可能会延长体采集时间,需要仔细规划干细胞调动.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 达拉图穆马布四倍诱导现在是新诊断的多发性骨髓瘤的移植合格标准.
- 达拉图穆马布的免疫抑制性质引起了人们对其对干细胞调动的影响的担忧.
- 以前的研究表明,达拉图姆巴的干细胞动员产量可能会受到损害.
研究的目的:
- 为了比较新诊断多发性骨髓瘤患者的干细胞调动产量.
- 评估含达拉图马布的四重诱导与传统的三药诱导对CD34+细胞采集的影响.
- 为了评估两个治疗臂的异体采集的持续时间.
主要方法:
- 对104名新诊断多发性骨髓瘤患者进行了回顾性研究.
- 在含有daratumumab的四重和三重药物诱导方案之间,对干细胞调动产生的比较.
- 在第一次动员尝试后分析CD34+细胞产量和非持续时间.
主要成果:
- 在第一次动员尝试 (P = 0.28) 后,在达到最低要求的CD34+细胞产量方面没有统计学上显著的差异.
- 在含有达拉图马布的手臂中,非收集持续时间明显较长 (中位数为2天与1天,P = 0.011).
- 证明对初始干细胞采集成功没有负面影响.
结论:
- 含达拉图马布的诱导疗法不会阻碍实现自主移植的目标CD34+细胞产量.
- 达拉图穆马布治疗患者的长时间阿菲雷斯持续时间突出了对优化后勤和资源配置的需求.
- 加强对这些患者的动员策略中使用颗粒细胞殖民地刺激因子和plerixafor.
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