ISSN: 1859 - 2872
Evaluating the effectiveness of hematopoietic stem cell mobilization from bone marrow to peripheral blood in multiple myeloma patients
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Abstract
Objective: To evaluate the effectiveness of CD34+ hematopoietic stem cell mobilization from the bone marrow into peripheral blood in patients with multiple myeloma by cyclophosphamide combined with granulocyte colony-stimulating factor (G-CSF) regimen at 108 Military Central Hospital from January 2017 to December 2021. Subject and method: Convenient sample collection method with 23 patients with multiple myeloma were indicated to mobilize CD34+ hematopoietic stem cell from bone marrow to peripheral blood for supportive treatment. The method study: A cross-sectional description study. Each patient received cyclophosphamide at a dose of 2 - 3g/m2 of skin on day N0. Then G-CSF was used at a dose of 5µl/kg/12h continuously from third day until the end of the mobilization period. Indicators monitored during the mobilization period included: Complete blood cell count by laser counter (daily); coagulation, basic biochemistry parameters (before, during, after the mobilization process); CD34+ test in peripheral blood performed after G-CSF administration and peripheral blood leukocyte count above 4G/L. The apheresis process was performed when peripheral blood CD34+ was above 10 cells/µl. Resµlt: The mean age of the study subjects was 51.78 ± 8.69 years old, the average mobilization day was 8.96 ± 2.43 days and the number of days of apheresis process to achieve the required cell dose was 1.74 ± 0.62 days. Successful mobilization rate was 23/23 = 100%. The number and ratio of white blood cells changed markedly between the day of the apheresis process compared to before mobilization. There was a positive and close correlation between the number of CD34 in peripheral blood and the number of CD34+ in the product bag. Varying degrees of neutrophil leukopenia and thrombocytopenia were the most common adverse effects during mobilization and recovered completely after mobilization. Conclusion: Initial assessment of the process of mobilizing CD34+ hematopoietic stem cells from bone marrow to peripheral blood in patients with multiple myeloma at 108 Military Central Hospital by cyclophosphamide + G-CSF regimen is relatively safe and achieve high efficiency.
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