1.Inhibition of the mitochondrial metabolic enzyme OGDC affects erythroid development.
Bin HU ; Mao-Hua LI ; Han GONG ; Lu HAN ; Jing LIU
Acta Physiologica Sinica 2025;77(3):395-407
Mitochondrial metabolism is crucial for providing energy and heme precursors during erythroid development. Oxoglutarate dehydrogenase complex (OGDC) is a key enzyme in the mitochondrial tricarboxylic acid (TCA) cycle, and its level gradually increases during erythroid development, indicating its significant role in erythroid development. The aim of the present study was to explore the role and mechanism of OGDC in erythroid development. In this study, we treated erythroid progenitor cells with CPI-613, a novel lipoic acid analog that competitively inhibits OGDC. The results showed that CPI-613 inhibited erythropoietin (EPO)-induced differentiation and enucleation of human CD34+ hematopoietic stem cells into erythroid cells, suppressed cell proliferation, and induced apoptosis. The results of in vivo experiments showed that CPI-613 also hindered the recovery of mice from acute hemolytic anemia. Further mechanism research results showed that CPI-613 increased reactive oxygen species (ROS) in erythroid progenitor cells, inhibited mitochondrial respiration, caused mitochondrial damage, and suppressed heme synthesis, thereby inhibiting erythroid differentiation. Clinical research results showed that oxoglutarate dehydrogenase (OGDH) protein expression levels were up-regulated in bone marrow cells of polycythemia vera (PV) patients. Treatment with CPI-613 significantly inhibited the excessive proliferation and differentiation of erythroid progenitor cells of the PV patients. These findings demonstrates the critical role of OGDC in normal erythroid development, suggesting that inhibiting its activity could be a novel therapeutic strategy for treating PV.
Animals
;
Humans
;
Mitochondria/metabolism*
;
Mice
;
Ketoglutarate Dehydrogenase Complex/physiology*
;
Cell Differentiation/drug effects*
;
Cells, Cultured
;
Erythropoiesis/drug effects*
;
Reactive Oxygen Species/metabolism*
;
Cell Proliferation/drug effects*
;
Erythroid Precursor Cells/cytology*
;
Apoptosis/drug effects*
;
Thioctic Acid/pharmacology*
;
Caprylates
;
Sulfides
2.Mechanism of Qitu Erzhi Decoction against chemotherapy-induced myelosuppression based on network pharmacology and experimental validation.
Meng-Meng WANG ; Hao SUN ; Gao-Biao LI ; Yu-Fei YANG ; Bin HE
China Journal of Chinese Materia Medica 2025;50(3):719-731
To investigate the mechanism of Qitu Erzhi Decoction(QTEZ) in ameliorating chemotherapy-induced myelosuppression and the focus of its decomposed formulae on the effects of hematopoietic cells of the three lineages, respectively. Ultra performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS) was used to identify the components of QTEZ intestinal absorption liquid and obtain the target sites, which were intersected with chemotherapy-induced myelosuppression targets collected from several databases, including OMIM, and an interaction network was established based on network pharmacology for Gene Ontology(GO) functional analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis. Hematopoietic stem cells of mice were taken after intraperitoneal injection of 5-fluorouracil for myelosuppression modeling and randomly divided into the model group, Qitu Erzhi group, Astragali Radix-Angelicae Sinensis Radix group, Ligustri Lucidi Fructus-Ecliptae Herba group, Psoraleae Fructus-Cuscutae Semen group, and positive drug group, which were given the corresponding traditional Chinese medicine intestinal absorption liquid and the positive drug granulocyte colony-stimulating factor, respectively. The normal hematopoietic stem cells were taken as the control group and were given the intervention of normal saline. The proliferation of hematopoietic progenitor cells of three lineages was observed by flow cytometry, and the cell cycle and colony formation assay were observed. Western blot was used to verify the effect of QTEZ on the pathway proteins including phosphoinositide 3-kinase(PI3K), phosphorylated PI3K(p-PI3K), protein kinase B(AKT), and phosphorylated AKT(p-AKT). RT-qPCR and Western blot were used to detect the effects of QTEZ on cell cycle-related targets such as CDK inhibitor 1(P21), cyclin D1(CCND1), and cyclin-dependent kinase 4(CDK4). The results showed that a total of 158 components were identified by QTEZ, and 375 component and disease intersecting targets were obtained, 21 core components and 40 core targets were obtained after constructing the network, and GO and KEGG enrichment showed signaling pathways such as PI3K/AKT. QTEZ and its decomposed formulae could promote the 5-fluorouracil-blocked cell cycle to resume operation, and all of them had different degrees of restoration effects on the set of colonies, among which QTEZ had the best restoration effect, and the Astragali Radix-Angelicae Sinensis Radix group had a focused effect on colony forming unit-erythrocyte. Western blot results indicated that there was no significant difference in the expression levels of pathway proteins among the groups. RT-qPCR and Western blot results showed that QTEZ could down-regulate P21 and up-regulate the protein and mRNA expression of CDK4 and CCND1. In conclusion, QTEZ and its decomposed formulas can exert a protective effect on hematopoietic stem cells with 5-fluorouracil-induced myelosuppression by promoting the normal operation of the cell cycle and colony formation, and the mechanism may be related to the down-regulation of the cell cycle-related targets of P21 and the up-regulation of CDK4 and CCND1. In addition, Astragali Radix-Angelicae Sinensis Radix can have a targeted protective effect on erythrocytes.
Animals
;
Drugs, Chinese Herbal/chemistry*
;
Network Pharmacology
;
Mice
;
Fluorouracil/adverse effects*
;
Male
;
Antineoplastic Agents/adverse effects*
;
Hematopoietic Stem Cells/cytology*
;
Humans
;
Signal Transduction/drug effects*
3.5-HT Promotes Proliferation and Inhibits Apoptosis of Megakarycytes through 5-HT2BR.
Hui-Min KONG ; Yu-Rong CEN ; Mo YANG ; Qiang PENG ; Jin-Qi HUANG
Journal of Experimental Hematology 2025;33(1):75-81
OBJECTIVE:
To investigate the effect of 5-hydroxytryptamine (5-HT) on the proliferation, apoptosis and colony-forming unit-megakaryocyte (CFU-MK) of Meg-01 cells and its possible mechanisms.
METHODS:
The uptake and metabolism of 5-HT in Meg-01 cells were analysed by reverse-phase high-performance liquid chromatography (RP-HPLC) with electrochemical detection. The expression of 5-HT2B receptor (5-HT2BR) in megakaryocytes was detected by immunofluorescence staining. The cell proliferation and viability were measured by MTT and Trypan blue staining after Meg-01 cells were single-cultured or co-cultured with different concentrations of 5-HT/5-HT2BR inhibitor Ketanserin for 48 h. Meg-01 cells were incubated with 5-HT/ Ketanserin for 72 h, then the flow cytometry was used to detect early apoptosis of the cells and the activity of caspase-3. Using CFU-MK assay to investigate the effect of 5-HT on the differentiation of megakaryocytes.
RESULTS:
5-HT could be uptaken by Meg-01 cells, and metabolized into 5-hydroxyindoleacetic acid (5-HIAA). The expression of 5-HT2BR on megakaryocytes could be detected after immunofluorescence staining. 5-HT could promote the proliferation of Meg-01 cells at a dose-dependent manner (r =0.82), with the most significant effect observed at a concentration of 200 nmol/L (P < 0.001). Trypan blue staining also indicated that 200 nmol/L 5-HT had the most significant effect on the viability of Meg-01 cells (P < 0.05). The proliferation of Meg-01 cells treated with 5-HT was increased compared with the untreated control (P < 0.001), while the combination of 5-HT with ketanserin downregulated this effect. 5-HT significantly reduced the early apoptosis rate (P < 0.001) and caspase-3 activity (P < 0.05) of Meg-01 cells, while addition of ketanserin significantly increased the early apoptosis rate of Meg-01 cells (P < 0.001) and caspase-3 activity also increased to some extent. 5-HT promoted the formation of CFU-MK in bone marrow cells in a dose-dependent manner (r =0.89). The addition of ketanserin reduced the promoting effect of 5-HT on CFU-MK formation (P < 0.01).
CONCLUSION
There may be monoamine oxidase present in megakaryocytes, which can metabolize and decompose 5-HT into 5-HIAA. 5-HT may promote the proliferation and differentiation of megakaryocytes through 5-HT2BR. Besides, 5-HT can also reduce the apoptosis of megakaryocytes, and its anti-apoptotic effect may be mediated by 5-HT2BR and caspase-3 pathways.
Apoptosis/drug effects*
;
Cell Proliferation/drug effects*
;
Megakaryocytes/metabolism*
;
Serotonin/pharmacology*
;
Humans
;
Receptor, Serotonin, 5-HT2B/metabolism*
;
Caspase 3/metabolism*
;
Cell Differentiation
4.Advances in Study of Erythroblastic Island Macrophages--Review.
Journal of Experimental Hematology 2025;33(1):292-295
Bone marrow microenvironment is the environment in which hematopoietic stem cells live, mainly composed of bone marrow stromal cells, microvessels, nerves, and cytokines secreted by stromal cells. The bone marrow microenvironment plays a crucial role in the self-renewal, directed differentiation and proliferation of hematopoietic stem cells and the regulation of proliferation, differentiation and maturation of hematopoietic cells. A class of macrophages exists in the bone marrow microenvironment, the bone marrow-resident tissue macrophages, which plays a crucial role in maintaining homeostasis in vivo, and three subpopulations of bone marrow-resident tissue macrophages have been characterized: erythroblastic island macrophages (EIMs), hematopoietic stem cell niche macrophages, and bone macrophages. This review focuses on the functions, surface markers and modeling of EIMs.
Macrophages/cytology*
;
Humans
;
Erythroblasts/cytology*
;
Animals
;
Hematopoietic Stem Cells/cytology*
5.Immunophenotypic Characteristics of Bone Marrow Granulocytes and Their Clinical Significance in Patients with Multiple Myeloma.
Ning-Fang WANG ; Chong-Shan ZHAO ; Dong-Dong ZHANG ; Zhuo-Wen CAI ; Fang-Fang CAI ; Fang LIU ; Peng-Hao ZHAO
Journal of Experimental Hematology 2025;33(2):447-454
OBJECTIVE:
To explore the immunophenotypic characteristics of bone marrow granulocytes (G) and their clinical significance in patients with multiple myeloma (MM).
METHODS:
The granulocyte immunophenotypes of bone marrow in 70 MM patients (MM group) and 40 anemia patients (control group) were detected by flow cytometry, and its correlation with clinical characteristics was further analyzed. Univariate and multivariate regression analysis were used to screen factors that affected prognosis.
RESULTS:
The CD56+G%, CD13+G%, CD22+G% and CD117+G% in MM group were higher than those in the control group (all P <0.05). CD56+G% and CD117+G% in CR+VGPR group were significantly lower than those in PR+MR+PD group (both P <0.05). The CD10+G% in RISS Ⅲ stage and Ca2+ ≥2.65 mmol/L groups were increased (both P <0.05). The CD56+G% in elevated lactate dehydrogenase, β2-microglobulin≥5.5 mg/L and hemoglobin <85 g/L groups were increased (all P <0.05), while the CD117+G% in high-risk cytogenetic positive group was decreased (P <0.05). The expression rate of CD molecules on granulocytes was divided into low (L) and high (H) groups according to the median value. The overall survival (OS) of the LCD56+G%, LCD13+G% and LCD22+G% groups was significantly prolonged (all P <0.05). CD13+G% and CD22+G% were independent risk factors for OS in MM patients (HR=0.443, 0.410, both P <0.05).
CONCLUSION
The CD56+G%, CD10+G% and CD117+G% are closely correlated with clinical features in MM patients, while CD13+G% and CD22+G% are closely correlated with prognosis. Detection of CD molecules expression on granulocytes may be used to evaluate prognosis and guide treatment.
Humans
;
Multiple Myeloma/immunology*
;
Granulocytes/immunology*
;
Prognosis
;
Immunophenotyping
;
Male
;
Bone Marrow
;
Female
;
Flow Cytometry
;
Middle Aged
;
Aged
;
Clinical Relevance
6.The Influence of COVID-19 Infection on the Mobilization and Collection of Autologous Peripheral Blood Stem Cells in Patients with Multiple Myeloma.
Guo-Rong WANG ; Guang-Zhong YANG ; Yun LENG ; Yin WU ; Ai-Jun LIU ; Wen-Ming CHEN
Journal of Experimental Hematology 2025;33(2):455-462
OBJECTIVE:
To analyze the effect of COVID-19 infection on the mobilization and collection of autologous peripheral blood stem cells in patients with multiple myeloma.
METHODS:
The general baseline data, treatment factors before mobilization collection, collection status, and treatment overview after collection of autologous peripheral blood stem cells at Beijing Chaoyang Hospital affiliated with Capital Medical University from January 1, 2020 to July 15, 2023 were analyzed.
RESULTS:
269 patients underwent mobilization and collection of autologous peripheral blood stem cells. Among them, 32 cases with COVID-19 infection history (COVID-19 group) and 237 cases without COVID-19 infection history (non-COVID-19 group). In the COVID-19 group, 17 cases were treated with chemotherapy (etoposide)+G-CSF, and 15 cases were treated with plerixafor +G-CSF. In the non-COVID-19 group, 214 cases were treated with chemotherapy +G-CSF, 17 cases were treated with plerixafor +G-CSF, and 6 cases were treated with chemotherapy + plerixafor +G-CSF. The number of CD34+ cells, collection success rate, and excellence rate in the COVID-19 group and the non-COVID-19 group were [5.52 (0.94-26.87) vs 4.80 (0.53-37.20)]×106/kg (P =0.610), (93.8% vs 85.2%) (P =0.275), (62.5% vs 49.4%) (P =0.190), respectively. Among 113 patients mobilized with etoposide +G-CSF, the number of CD34+ cells, success rate, and excellence rate collected from COVID-19 infection (17 cases) and non-COVID-19 infection (96 cases) were [7.54 (2.66-26.87) vs 7.78 (2.26-37.20)]×106/kg (P =0.847), (100.0% vs 100.0%) (no P value), (82.4% vs 86.5%) (P =0.655), respectively. Among 32 patients mobilized by plerixafor +G-CSF, the number of CD34+ cells, success rate and excellence rate of COVID-19 infection (15 cases) and non-COVID-19 infection (17 cases) were [3.82 (0.94-7.27) vs 4.11 (0.53-9.05)]×106/kg (P =0.821), (86.7% vs 88.2%) (P =0.893), (40.0% vs 35.3%) (P =0.784), respectively. In 32 patients with COVID-19 infection, the number of CD34+ cells collected by etoposide +G-CSF (17 cases) and plerixafor +G-CSF (15 cases), as well as the success rate and excellence rate were [7.54 (2.66-26.87) vs 3.82(0.94-7.27)]×106/kg (P =0.004), (100.0% vs 86.7%) (P =0.120), (82.4% vs 40.0%) (P =0.014), respectively. By 2023.7.31, 232 patients (86.2%, 232/269) had received transplantation, including 24 patients in the COVID-19 group and 208 patients in the non-COVID-19 group. The median number of CD34+ cells infused in the two groups was [3.67 (2.50-13.44) vs 3.11(1.12-19.89)]×106/kg (P =0.058), the median days of neutrophil engraftment [11(9-13) vs 11(9-17)] (P =0.674), the median days of platelet engraftment [11(0-23), 12(0-43)] (P =0.279), respectively.
CONCLUSION
The history of COVID-19 infection did not affect the PBSC mobilization, collection and transplantation of patients with myeloma. In patients with COVID-19 infection, the results of chemotherapy mobilization with etoposide seems to be better than that of plerixafor mobilization, but further research is needed to clarify.
Humans
;
COVID-19/complications*
;
Multiple Myeloma/complications*
;
Hematopoietic Stem Cell Mobilization
;
Transplantation, Autologous
;
Granulocyte Colony-Stimulating Factor/therapeutic use*
;
Peripheral Blood Stem Cell Transplantation
;
SARS-CoV-2
;
Middle Aged
;
Peripheral Blood Stem Cells
;
Male
;
Female
;
Cyclams
;
Benzylamines
7.Research Progress of the Wnt/β-catenin Signaling Pathway in the Regulation of Oxidative Stress and Its Impact on the Hematopoietic System --Review.
Journal of Experimental Hematology 2025;33(3):927-930
Excessive generation of reactive oxygen species (ROS) can lead to oxidative-antioxidative imbalance in the organism, resulting in oxidative stress. Hematopoietic stem/progenitor cells (HSPCs) exhibit high sensitivity to changes in ROS levels, and high levels of ROS can impair self-renewal capacity of HSPCs, leading to oxidative damage and even death. Wnt/β-catenin signaling pathway regulates hematopoiesis and plays an important role in determining the fate of stem cells, such as self-renewal, proliferation and differentiation of HSPCs. Studies have shown that Wnt/β-catenin signaling pathway is also closely related to oxidative stress. This article summarizes the relevant literature, and reviews the role of Wnt/β-catenin signaling pathway in oxidative stress, its impact on hematopoietic system, and the current research status of related mechanisms.
Oxidative Stress
;
Humans
;
Wnt Signaling Pathway
;
Hematopoietic Stem Cells
;
Reactive Oxygen Species/metabolism*
;
Hematopoietic System/metabolism*
;
beta Catenin/metabolism*
;
Hematopoiesis
8.Correlation Analysis between Immune Cells in Graft and Early Immune Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation.
Shan WANG ; Fan LIU ; Qiu-Juan ZHU ; Tao WANG ; Rong GONG ; Wei-Wei TIAN ; Zhi-Lin GAO
Journal of Experimental Hematology 2025;33(4):1173-1180
OBJECTIVE:
To investigate the correlation between the types and quantities of immune cells in the graft and early immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their influence on clinical prognosis.
METHODS:
The clinical data of 83 patients with hematological diseases who received allo-HSCT in Shanxi Bethune Hospital from September 2020 to June 2023 were retrospectively analyzed. The number of mononuclear cells (MNC), CD34+ cells and lymphocyte subsets (including CD3+T, CD3+CD4+T(Th), CD3+CD8+T(Ts), NK cells and B cells) infused into the recipients was counted, and the peripheral blood lymphocytes were detected before conditioning and on days 14, 30, 60 and 100 post-HSCT.
RESULTS:
Multivariate analysis showed that the number of MNC in the graft affected the recovery of CD4+T lymphocytes after HSCT, and the number of CD4+T lymphocytes in the graft affected the recovery of NK cells and B cells after HSCT. The patient age, donor sex, stem cell source, degree of HLA matching, use of ATG before HSCT, the occurrence of acute graft-versus-host disease (aGVHD) after HSCT, and viral infection all affect the early cellular immune reconstitution post-HSCT. The number of infused cells had no significant impact on the median engraftment time for neutrophils and platelets after HSCT. Patients with lower numbers of CD3+T, CD4+T and B cells in the graft were more prone to viral infection after HSCT. However, the cells in the graft had no significant effect on disease recurrence or mortality.
CONCLUSION
The recovery rate of lymphocyte count after allo-HSCT varies. The numbers of MNC and CD4+T cells in the graft may be related to the cellular immune reconstitution after HSCT, while the numbers of CD34+,CD3+T,CD8+T,NK and B cells have no significant effect on the cellular immune reconstruction. The numbers of CD3+T,CD4+T and B cells in the graft were negatively correlated with viral infection after HSCT, but the cellular components of the graft have no obvious influence on hematopoietic reconstitution, disease recurrence, death, recurrence-free survival(RFS) and overall survival(OS) after HSCT.
Humans
;
Hematopoietic Stem Cell Transplantation
;
Immune Reconstitution
;
Transplantation, Homologous
;
Retrospective Studies
;
Graft vs Host Disease/immunology*
;
Male
;
Female
;
Killer Cells, Natural/immunology*
;
Adult
;
Middle Aged
;
B-Lymphocytes/immunology*
;
Prognosis
;
Lymphocyte Subsets/immunology*
;
Adolescent
9.Effects of Total Body Irradiation with 60 Co Gamma Ray at Different Dose Rates on Hematopoietic and Immune Cells in Mice.
Hui SHU ; Ya DONG ; Xue-Wen ZHANG ; Xing SHEN ; Shuang XING ; Zu-Yin YU
Journal of Experimental Hematology 2025;33(4):1181-1189
OBJECTIVE:
To investigate the effect of irradiation dose rate of 60Co γ-ray on hematopoietic and immune cells in total body irradiation (TBI) mice.
METHODS:
After TBI with 8 Gy 60Co γ-ray at three irradiation dose rates of 0.027, 0.256 and 0.597 Gy/min, the survival and change of body weight of C57BL/6J mice were observed within 30 days. The peripheral blood parameters were examined at each time point within 30 days post-irradiation. The hematopoietic stem/progenitor cell counts of mice were examined on the 10th and 30th day post-irradiation by flow cytometry, as well as the proportions of immune cells in peripheral blood, bone marrow and spleen of mice on the 30th day post-irradiation.
RESULTS:
After TBI with 8 Gy 60Co γ-ray, the 30-day survival rate of high dose-rate group was 0, which was significantly lower than 90% of medium dose-rate group and 100% of low dose-rate group (both P < 0.001). The peripheral blood parameters of all three groups showed a sharp decline → low value → gradually recovering trend. The count of white blood cell, neutrophil, lymphocyte, red blood cell, platelet and hemoglobin level in the high dose-rate and medium dose-rate groups were significantly lower than those in the low dose-rate group on day 7-18 post-irradiation (all P < 0.05), but there were no significant differences between the high dose-rate and medium dose-rate groups (P >0.05). On the 10th day after irradiation, the proportion and number of bone marrow hematopoietic stem/progenitor cells (including LK, LSK, LT-HSC, ST-HSC, and MPP cells) in the low dose-rate and medium dose-rate groups were significantly decreased compared to those in the normal group (all P < 0.05), but there were no significant differences between the two groups (P >0.05). On the 30th day after irradiation, LSK, LT-HSC, ST-HSC and MPP cells in the low dose-rate group recovered to normal levels, while those in the medium dose-rate group were still significantly lower than those in the low dose-rate group (all P < 0.001). The results of bone marrow and peripheral immune cell tests on the 30th day after irradiation showed that the ratios of T and B lymphocytes in the low dose-rate and medium dose-rate groups were reduced compared to that in the normal group (both P < 0.05), while the ratio of neutrophils was increased (P < 0.01). The trend of changes in the spleen and peripheral blood was consistent.
CONCLUSION
The degree of hematopoietic and immune cell damage in mice after TBI with 8 Gy 60Co γ-ray is related to the dose rate, and low dose-rate irradiation can reduce the damage in the animal model. Therefore, choosing the appropriate dose rate of irradiation is a key factor in establishing an objective and reliable experimental animal model of irradiation.
Animals
;
Mice
;
Whole-Body Irradiation
;
Gamma Rays
;
Mice, Inbred C57BL
;
Hematopoietic Stem Cells/radiation effects*
;
Cobalt Radioisotopes
;
Dose-Response Relationship, Radiation
;
Male
10.Effective Salvage Mobilization of Peripheral Blood Stem Cells with High-Dose Etoposide in Newly Diagnosed Multiple Myeloma Patients Who Failed Initial Mobilization with High-Dose Cyclophosphamide.
Yue-Qi WANG ; Shi-Hua ZHAO ; Yi MA ; Xi-Lin CHEN ; Shun-Zong YUAN ; Na-Na CHENG ; Guang-Ning SHI ; Wen-Rong HUANG ; Xiu-Bin XIAO
Journal of Experimental Hematology 2025;33(5):1380-1385
OBJECTIVE:
To explore the safety and efficacy of high-dose etoposide (VP-16) combined with recombinant human granulocyte colony-stimulating factor (rhG-CSF) as salvage mobilization for peripheral blood stem cells (PBSC) in newly diagnosed multiple myeloma (NDMM) patients.
METHODS:
From April 2021 to May 2023, eight NDMM patients who had failed to yield sufficient PBSC during initial mobilization with high-dose cyclophosphamide (CTX) combined with rhG-CSF underwent salvage mobilization with 1.2 g/m2 etoposide combined with rhG-CSF 10 μg/(kg·d). The effects and adverse reactions of initial mobilization and salvage mobilization were analyzed.
RESULTS:
For salvage mobilization and initial mobilization, the numbers of PBSC collections were 16 and 18, respectively. The mean value of total collected CD34+ cells were (11.90±5.75)×106/kg and (1.67±0.75)×106/kg (P =0.0010) in salvage mobilization group and initial mobilization group, respectively. The proportion of patients with a total collection of CD34+ cell count≥2×106/kg were 100% and 37.5% (P =0.0625), and the proportion of patients with a total collection of CD34+ cell count≥5×106/kg were 87.5% and 0% (P =0.0156) in salvage mobilization group and initial mobilization group, respectively. For five patients who underwent high-dose CTX initial mobilization but had a total CD34+ cell count < 2×106/kg, successful collection was achieved through salvage mobilization with high-dose VP-16. Salvage mobilization with high-dose VP-16 was scheduled 2-3 weeks after failure of CTX mobilization. Adverse reactions of high-dose VP-16 mobilization did not increase compared to the initial mobilization with high-dose CTX.
CONCLUSION
As a salvage mobilization regimen, VP-16 1.2 g/m2 combined with rhG-CSF is safe and highly effective in NDMM patients who failed to initial mobilization with high-dose CTX combined with rhG-CSF.
Humans
;
Multiple Myeloma/therapy*
;
Etoposide/therapeutic use*
;
Hematopoietic Stem Cell Mobilization/methods*
;
Cyclophosphamide/therapeutic use*
;
Granulocyte Colony-Stimulating Factor
;
Salvage Therapy
;
Peripheral Blood Stem Cells
;
Male
;
Middle Aged
;
Female
;
Peripheral Blood Stem Cell Transplantation

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