Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

Gertz, Morie A.; Wolf, Robert C.; Micallef, Ivana N.; Gastineau, Dennis A.

doi:10.1038/bmt.2009.370

Cited by 75 publications

(77 citation statements)

References 57 publications

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“…Additional mobilization attempts result in increased use of growth factors and antibiotics, increased transfusional support, more apheresis procedures, and more frequent hospitalizations leading to increased morbidity and cost, and can delay ASCT, if not preclude it altogether [15][16][17][18]. Patients remobilized with G-CSF 1 plerixafor had lower failure rates than those remobilized with G/C, G-CSF, and/or GM-CSF, but plerixafor adds significant cost [18][19][20]. Early identification of patients likely to fail during their initial mobilization attempt could trigger intervention in these high-risk patients to improve collection.…”

Section: Discussionmentioning

confidence: 99%

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

Duong

Bolwell

Rybicki

et al. 2011

J of Clinical Apheresis

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Early and reliable prediction of the likelihood of achieving adequate stem cell collection for autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM) would improve collection efficiency, prevent unnecessary aphereses, and permit appropriate treatment alterations. No previous study has reported a threshold CD34+ cell collection quantity on Day 1 or 2 of leukapheresis that could predict successful stem cell collection. We performed a retrospective analysis of all MM patients undergoing first attempt of stem cell collection at our institution from 2001 through 2008. Recursive partitioning analysis was used to identify Day 1 or Day 1+2 CD34+ collection quantity that predicted failure to reach target ≥ 2 × 10(6) CD34+ cells/kg within five days of collection. Totally, 172 patients were included in the analysis. Patients underwent mobilization with G-CSF or G-CSF+ chemotherapy. 23 of 172 patients (13.4%) failed to collect sufficient (≥ 2 × 10(6) CD34+ cells/kg) CD34+ cells after five days of apheresis: 22 of 29 who collected ≤ 0.70 × 10(6) CD34+ cells/kg and 1 of 143 who collected > 0.70 × 10(6) CD34+ cells/kg (75.9% vs. 0.7%, P < 0.001) on Day 1. Collection failure occurred in 23 of 30 patients who collected ≤ 1.54 × 10(6) CD34+ cells/kg and 0 of 142 who collected >1.54 × 10(6) CD34+ cells/kg (76.7% vs. 0%, P < 0.001) on Days 1 + 2. Day 1 CD34+ cell collection quantity identifies patients unlikely to achieve adequate collection for ASCT. Patients who collect ≤ 0.70 × 10(6) CD34+ cells/kg on day 1 could be considered for treatment modifications to improve CD34+ collection, such as early administration of plerixafor or large volume apheresis.

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Section: Discussionmentioning

confidence: 99%

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

Duong

Bolwell

Rybicki

et al. 2011

J of Clinical Apheresis

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“…6 Although SCM using CY þ G is among the standards of care for the treatment of lymphoma and MM, our study suggests that there is the potential for alternative strategies to further improve outcomes with the adoption of cost-effective treatments. CY has the added potential of decreasing tumor load while aiding SCM.…”

Section: Discussionmentioning

confidence: 99%

Outcome, toxicity profile and cost analysis of autologous stem cell mobilization

Jagasia

Savani

Neff

et al. 2010

Bone Marrow Transplant

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“…2,3 Also, a considerable proportion of patients without obvious risk factors for poor mobilization and up to 20% of healthy donors fail to increase sufficiently the number of progenitors in response to G-CSF, being idiopathic 'poor mobilizers'. [4][5][6] Plerixafor is a small molecule inhibitor of the CXCR4 chemokine receptor and blocks binding to its ligand, stromal cell-derived factor-1 alpha (SDF-1α). Devine et al 7 showed that a single subcutaneous dose of plerixafor led to a sixfold increase in circulating CD34+ cells in patients with non-Hodgkin's lymphoma and multiple myeloma.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of plerixafor in children with malignant tumors failing to mobilize a sufficient number of hematopoietic progenitors with G-CSF

Maschan

Balashov

Kurnikova

et al. 2015

Bone Marrow Transplant

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Mobilization of suitable amounts of PBSCs with granulocyte-CSF (G-CSF) can be difficult in children. We report the results of using plerixafor in pediatric patients who failed to mobilize progenitors with G-CSF-based regimens. Thirty-three patients, median age 9 years (range 1-18 years) and median weight 29 kg (range 10-85 kg) were enrolled into the study. After 4 days of G-CSF stimulation, the median CD34+ cell count in peripheral blood was 10.4 per μL (range 0.27-23.0 per μL). Plerixafor was administered subcutaneously (0.24 μg/kg in 30 patients and 0.3 μg/kg in 3 patients) 11-12 h before apheresis. At the time of apheresis, CD34+ cell counts increased to a median of 44.1 per μL (range 8.4-357.0 per μL), a median 4.4-fold increase. Two patients (6%) failed to mobilize. Thirty-one patients underwent apheresis and in 27 42 × 10 6 CD34+ cells per kg of body weight were collected after one procedure. In total, 31 of 33 patients mobilized successfully and the median number of cryopreserved CD34+ cells was 5.6 × 10 6 /kg body weight (2.7 × 10 6 -27.4 × 10 6 ). Twenty-four patients underwent transplantation. Engraftment was achieved in all but one patient, who died on day +9 after hematopoietic stem cell transplantation. The median time of neutrophil and platelet recovery was day +12 and +16, respectively. Our study confirms that plerixafor has impressive efficacy and very modest toxicity in children.

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Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

Cited by 75 publications

References 57 publications

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

Outcome, toxicity profile and cost analysis of autologous stem cell mobilization

Efficacy of plerixafor in children with malignant tumors failing to mobilize a sufficient number of hematopoietic progenitors with G-CSF

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