Retrospective Study Of Etoposide Combined With Pegylated Recombinant Human Granulocyte Colony-stimulating Factor For Mobilization Of Autologous Peripheral Blood Hematopoietic Stem Cells In Lymphoma Patients

Background&Objective: High dose chemotherapy(HDC)combined with autologous peripheral blood stem cell transplantation(APBSCT)is still an effective treatment for patients with malignant lymphoma.Effective mobilization and collection of peripheral blood stem cell(PBSC)is the prerequisite to ensure the smooth implementation of transplantation.To explore more efficient and rapid mobilization regimen,provide more clinical basis for clinician to choose treatment plan,this article compared the efficacy between etoposide(VP-16)combined with pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)and cyclophosphamide(CTX)combined with recombinant human granulocyte colony-stimulating factor(rhG-CSF)for the mobilization of PBSC and hematopoietic recovery after transplantation in 31 cases of patients with lymphoma in our hospital.Methods: A retrospective study of autologous PBSC mobilization data of 31 lymphoma patients who were treated with VP-16 plus PEG-rhG-CSF or CTX plus rhG-CSF from March 2014 to November 2019 in Department of Hematology,Union Hospital,Tongji Medical College of Huazhong University of Science and Technology was conducted.The mobilization efficacy and hematopoietic recovery were analyzed.Results:(1)The successful rate of the first collection,the first two times collections and the overall collections in the VP-16+PEG-rhG-CSF group were significantly better than those in the CTX+rhG-CSF group(all P<0.05).(2)The excellent rate of the first two times collections and the overall collections in the VP-16+PEG-rhG-CSF group were significantly better than those in the CTX+rhG-CSF group(all P<0.05).However,there was no significant difference between the two groups in the excellent rate of the first collection(P>0.05).(3)The CD34~+cell count in the first collection,the first two times collections and the total collections in the VP-16+PEG-rhG-CSF group were significantly better than those in the CTX+rhG-CSF group(all P<0.05).(4)The first collection time in the VP-16+PEG-rhG-CSF group was 4 days earlier than that in the CTX+rhG-CSF group.(5)There was no significant difference in the collection times between the two groups(P>0.05).(6)There was no significant difference between the two groups in the myelosuppression and febrile neutropenia during mobilization(all P>0.05),and no fatal infection or treatment-related death occurred in all patients.(7)There was no significant difference in the number of implanted CD34~+cells and hematopoietic recovery time after transplantation between the two groups(P>0.05).Conclusion: Compared with CTX combined with rhG-CSF,the mobilization of VP-16 combined with PEG-rhG-CSF is more convenient,rapid and efficient,with good tolerance,which can be used as an alternative mobilization regimen for PBSC mobilization of lymphoma patients.