Blood stem cell mobilization and collection in patients with chronic lymphocytic leukaemia: a nationwide analysis

Jantunen, Esa; Itälä, M; Siitonen, Timo; Kuittinen, Taru; Heiskanen, Jouni; Koivunen, E; Juvonen, Eeva; Silvennoinen, Raija; Nousiainen, Tapio; Koistinen, Pirjo; Volin, Liisa; Remes, Kari

doi:10.1038/sj.bmt.1705897

Cited by 20 publications

(17 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, different reports suggest that previous therapy with purine analogues may impair the ability to mobilize PBSC in sufficient numbers for transplants. 25 We did not observe these difficulties, probably because other factors such as the number of previous therapeutic regimens and the time of mobilization may affect the ability to mobilize stem cells. In the future, new mobilization agents like plerixafor can overcome these difficulties.…”

Section: Discussionmentioning

confidence: 96%

Autologous transplantation in CLL patients with B and C Binet stages: final results of the prospective randomized GOELAMS LLC 98 trial

Brion

Mahé

Kolb

et al. 2011

Bone Marrow Transplant

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 96%

Autologous transplantation in CLL patients with B and C Binet stages: final results of the prospective randomized GOELAMS LLC 98 trial

Brion

Mahé

Kolb

et al. 2011

Bone Marrow Transplant

View full text Add to dashboard Cite

“…The average decrease estimated for each cycle of chemotherapy is of 0.2 × 10 6 CD34 + cells per kg per apheresis and 1.8 × 10 6 /kg CD34 + cells after large-field radiotherapy, whereas a local irradiation is not associated with impaired mobilization. 36, 48, 68, 69, 71 Although underlying disease has been reported as a factor influencing mobilization, 49, 53, 54, 55, 56 GITMO-WG deemed that this is not an independent factor, being influenced by the previous treatment and by the disease status. Advanced disease is often associated with extensive BM involvement.…”

Section: Discussionmentioning

confidence: 99%

Proposed definition of ‘poor mobilizer’ in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo ItalianoTrapianto di Midollo Osseo

Olivieri

Marchetti

Lemoli

et al. 2011

Bone Marrow Transplant

162

129

View full text Add to dashboard Cite

Many lymphoma and myeloma patients fail to undergo ASCT owing to poor mobilization. Identification of poor mobilizers (PMs) would provide a tool for early intervention with new mobilization agents. The Gruppo italianoTrapianto di Midollo Osseo working group proposed a definition of PMs applicable to clinical trials and clinical practice. The analytic hierarchy process, a method for group decision making, was used in setting prioritized criteria. Lymphoma or myeloma patients were defined as ‘proven PM' when: (1) after adequate mobilization (G-CSF 10 μg/kg if used alone or ⩾5 μg/kg after chemotherapy) circulating CD34+ cell peak is <20/μL up to 6 days after mobilization with G-CSF or up to 20 days after chemotherapy and G-CSF or (2) they yielded <2.0 × 106 CD34+ cells per kg in ⩽3 apheresis. Patients were defined as predicted PMs if: (1) they failed a previous collection attempt (not otherwise specified); (2) they previously received extensive radiotherapy or full courses of therapy affecting SC mobilization; and (3) they met two of the following criteria: advanced disease (⩾2 lines of chemotherapy), refractory disease, extensive BM involvement or cellularity <30% at the time of mobilization; age ⩾65 years. This definition of proven and predicted PMs should be validated in clinical trials and common clinical practice.

show abstract

“…Moreover, baseline thrombocytopenia (quoted thresholds range from Ͻ 100 to Ͻ 150 ϫ 10 9 /L) 83,131 has been consistently associated with poor mobilization.…”

Section: Plerixaformentioning

confidence: 99%

How I treat patients who mobilize hematopoietic stem cells poorly

Levesque

Herbert

2011

Blood

218

235

View full text Add to dashboard Cite

Transplantation with 2-5 ؋ 10 6 mobilized CD34 ؉ cells/kg body weight lowers transplantation costs and mortality. Mobilization is most commonly performed with recombinant human G-CSF with or without chemotherapy, but a proportion of patients/donors fail to mobilize sufficient cells. BM disease, prior treatment, and age are factors influencing mobilization, but genetics also contributes. Mobilization may fail because of the changes affecting the HSC/progenitor cell/BM niche integrity and chemotaxis. Poor mobilization affects patient outcome and increases resource use. Until recently increasing G-CSF dose and adding SCF have been used in poor mobilizers with limited success. However, plerixafor through its rapid direct blockage of the CXCR4/CXCL12 chemotaxis pathway and synergy with G-CSF and chemotherapy has become a new and important agent for mobilization. Its efficacy in upfront and failed mobilizers is well established.To maximize HSC harvest in poor mobilizers the clinician needs to optimize current mobilization protocols and to integrate novel agents such as plerixafor. These include when to mobilize in relation to chemotherapy, how to schedule and perform apheresis, how to identify IntroductionHematopoietic stem cell transplantation (HSCT) has revolutionized the curative approach to a number of malignancies and BM failure syndromes by providing hematopoietic and immune rescue after high-dose cytoreductive therapy and, in allogeneic transplantations, graft-versus-tumor effect. [1][2][3][4] The term "mobilization" was first used to describe a 4-fold increase of circulating myeloid progenitors (granulocyte macrophage CFU [CFU-GM]) after the administration of endotoxin to healthy volunteers in 1977. 5 High levels of CFU-GM after recovery from myelosuppressive chemotherapy in humans was first described in 1976. 6 However, it was not until the 1980s that the use of chemotherapy-mobilized HSCs for transplantation was established. [7][8][9] Subsequently, a single high-dose cyclophosphamide was developed as a generic mobilizer. 10 Prof Metcalf led the study that showed the potential of G-CSF in mobilization. 11 Subsequently, 2 Australian centers in Melbourne and Adelaide showed for the first time the use of G-CSF-mobilized HSCs for transplantation, 12 and reports of combined G-CSF and chemotherapy mobilization soon followed. 13 Now, virtually all autologous and three-quarters of allogeneic transplantations are performed with mobilized HSCs (CIBMTR reports). 14,15 The cell dose effect of HSCT describes a threshold of HSCs that, when transplanted, is associated with rapid and sustained blood count recovery. 16 The benefits of rapid recovery are reduced hospitalization, blood product usage, and infections. 12,17 The minimum threshold for autologous transplantation is currently defined as 2 ϫ 10 6 CD34 ϩ cells/kg body weight (BW). 18 Many centers use a minimum of 3 ϫ 10 6 CD34 ϩ cells/kg BW for myeloablative and nonmyeloablative allogeneic and matched unrelated transplantations. Furthermore, Ͼ 5 ϫ 10 6 CD3...

show abstract

Blood stem cell mobilization and collection in patients with chronic lymphocytic leukaemia: a nationwide analysis

Cited by 20 publications

References 30 publications

Autologous transplantation in CLL patients with B and C Binet stages: final results of the prospective randomized GOELAMS LLC 98 trial

Autologous transplantation in CLL patients with B and C Binet stages: final results of the prospective randomized GOELAMS LLC 98 trial

Proposed definition of ‘poor mobilizer’ in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo ItalianoTrapianto di Midollo Osseo

How I treat patients who mobilize hematopoietic stem cells poorly

Contact Info

Product

Resources

About