Application of Plerixafor combined with G-CSF in autologous stem cell transplantation in light chain amy-loidosis
Objective To analyze the efficacy and safety of thetherapy of Plerixafor combined with granulocyte colony-stimu-lating factor(G-CSF)for light chain amyloidosis(AL amyloidosis)in autologous stem cell transplantation(ASCT).Methods A total of 32 patients with AL amyloidosis who underwent ASCT using the combination of Plerixafor and G-CSF mobilization protocol at a National Center for Clinical Medical Research in Kidney Diseases from November 2022 to October 2023 were selected.Their baseline clinical data,collection of stem cell,hematopoietic reconstitution,and related adverse reactions were analyzed.Results In the 32 patients with AL type amyloidosis,after 3-5 days of mobilization with Plerixafor combined with G-CSF,the pre-collection CD34+cell count and the collected CD34+cell count were 106.00(80.25,180.25)/uL and(6.73±3.62),respectively×106/kg.Among 32 pa-tients,31 patients were qualified for collection on the first day,21 patients had excellent collection on the first day,and 32 patients were all collected successfully.The single collection pass rate was 96.88%,the single collection excellent rate was 65.63%,and the collection success rate was 100%;The median time for granulocyte implantation was 9(9,10)days,the median time for platelet implantation was 10(9,11)days,and the median time for neutrope-nia was 5(4,5)days.All 32 patients successfully completed hema-topoietic reconstruction.The adverse reactions related to mobilization were abdominal pain and diarrhea in 17 cases(53.13%),skeletal andmuscle soreness in 10 cases(31.25%),nausea and vomiting in 5 cases(15.63%),facial numbness in 2 cases(6.25%),and chest tightness in 1 case(3.13%),all of which were grade 1 and 2.The adverse reactions are mild and controllable,and the patients received rapid relief after symptomatic treatment.Conclusion The application of Plerixafor combined with G-CSF in autologous stem cell transplantation in light chain amyloidosis is effective and safe.
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