Poor Hemopoietic Stem Cell Mobilizers in Multiple Myeloma : A Single Institution Experience

Ruíz-Delgado, Guillermo J.; López-Otero, Avril; Hernández-Arizpe, Ana; Ramirez-Medina, Aura; Ruíz‐Argüelles, Guillermo J.

doi:10.4084/mjhid.2010.016

Cited by 3 publications

(2 citation statements)

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“…A single-center study with 28 myeloma patients investigated the OS and CD34+ cells infused. Their data showed the minimal CD34 + cell doses were 1.0 × 10 6 cells/kg and patients who transplanted less than this threshold had a shorter survival period (80% patients survived at 80 months for >1.0 × 10 6 CD34 + cells/kg infused and 67% at 76 months for <1.0 × 10 6 CD34 + cells/kg infused) [ 24 ]. A large cohort with 810 patients who underwent ASCT aimed to re-evaluate the threshold for minimal CD34 + cell doses for engraftment reported that 1−2 × 10 6 CD34 + cells/kg was acceptable [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with optimal CD34 + cells collected for the first 2 days received the third apheresis if tandem transplantation was planned or decided by the treating physician. A collection of less than 1 × 10 6 CD34 + cells/kg is defined as stem cell mobilization failure since the administration of stem cell doses <1 × 10 6 cells/kg has been associated with increased RBC transfusion requirement and engraftment failure in previous studies [ 21 , 22 , 23 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

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Risk Factors and Outcomes of Stem Cell Mobilization Failure in Multiple Myeloma Patients

Hsu

Tsai

Liu

et al. 2022

Transfus Med Hemother

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Introduction: Autologous hematopoietic stem cell transplantation (ASCT) is a well-established treatment for patients with multiple myeloma (MM), and adequate stem cell collection must be assured before ASCT. However, prediction of poor mobilizers (PMs) is still difficult despite several risk factors for mobilization failure having been identified. Methods: We retrospectively analyzed MM patients at Taipei Veterans General Hospital in Taiwan who underwent stem cell collection between October 2006 and August 2020. A CD34+ cell collection of <1 × 106 cells/kg was defined as a mobilization failure. The primary endpoint was mobilization failure. The secondary endpoint was overall survival (OS). Odds ratios (ORs) and 95% confidence intervals (CIs) for mobilization failure were calculated using a logistic regression model. The cumulative incidence of mortality was estimated using the Kaplan-Meier method. Results: In the multivariate analysis, absolute monocyte count <500/µL (adjusted OR 10.75, 95% CI: 1.82–63.57, p = 0.009), platelet count <150,000/µL (adjusted OR 12.49, 95% CI: 2.65–58.89, p = 0.001) before mobilization, and time interval from diagnosis to stem cell harvest ≥180 days (adjusted OR 7.69, 95% CI: 1.61–36.87, p = 0.011) were risk factors for PMs. PM patients had poorer OS compared to patients with successful stem cell collection in the univariate analysis (log-rank test p = 0.027). The predicted probability of PMs was estimated by the multiple logistic regression model with a sensitivity of 84.6% and a specificity of 84.0%. Conclusion: Absolute monocyte count <500/µL, platelet count <150,000/µL, and treatment duration more than 180 days before stem cell mobilization are risk factors for unsuccessful stem cell collection. Our prediction models have high sensitivity and specificity for mobilization failure prediction and allow for early interventions for possible PMs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Risk Factors and Outcomes of Stem Cell Mobilization Failure in Multiple Myeloma Patients

Hsu

Tsai

Liu

et al. 2022

Transfus Med Hemother

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Reduced‐dose plerixafor as a mobilization strategy in autologous hematopoietic cell transplantation: a proof of concept study

et al. 2019

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BACKGROUND Autologous stem cell transplantation (ASCT) is an effective treatment for patients with relapsing myeloma or lymphoma, diseases associated with unsuccessful peripheral blood stem cell (PBSC) collection. Plerixafor is a potent mobilizing agent, allowing more CD34+ cells to be obtained; however, the main obstacle for its use is its high cost. Our aim was to demonstrate that of the use of reduced doses of plerixafor (RD‐plerixafor) can be sufficient to collect at least 2 × 106/Kg CD34+ PBSC in patients with multiple myeloma (MM) or lymphoma undergoing ASCT. STUDY DESIGN AND METHODS Twenty patients were mobilized with filgrastim (10 μg/kg/4 days) plus a single dose of plerixafor 0.12 mg/kg in Day 4. Apheresis collection was performed on Day 5. One vial of plerixafor was used for two patients. http://clinicaltrials.gov NCT03244930. RESULTS Cell mobilization and collection was successful in 85% of patients (≥2 × 106 CD34+ cells per kilogram). The median collected CD34+ cell count was 4.62 × 106/kg (range, 1.27‐24.5). A 4.1‐fold‐increase in the median CD34+ PBSC pre‐count was observed (from 10.4/μl to 42.4/μl) after RD‐plerixafor administration. Seven patients had mild to moderate adverse events. CONCLUSION RD‐plerixafor is an effective, safe, and affordable strategy to ensure adequate PBSC mobilization in patients with MM or lymphoma who undergo ASCT.

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Factors Associated with Efficient Harvesting and Engraftment of Auto-Transplants in Multiple Myeloma Patients

Кострома¹,

Transfusiology²,

Zhernyakova³

et al. 2019

Клиническая онкогематология

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Актуальность. Успех трансплантации аутологичных гемопоэтических стволовых клеток (аутоТГСК) зависит от скорости приживления трансплантата, которая, в свою очередь, определяется количеством заготовленных и перелитых больному гемопоэтических стволовых клеток (ГСК). Цель. Определить предикторы эффективности ауто-ТГСК у больных множественной миеломой (ММ) в условиях применения новых лекарственных средств на этапе индукции и мобилизации ГСК. Материалы и методы. Проведен ретроспективный анализ результатов заготовки аутотрансплантата у 75 больных ММ и его приживления при выполнении 112 аутоТГСК. Для заготовки аутотрансплантата использовался циклофосфамид и винорелбин в комбинации с гранулоцитарным колониестимулирующим фактором (Г-КСФ) без дополнительного введения плериксафора. В качестве режима кондиционирования назначался мелфалан в дозе 200 или 140 мг/м 2 , а также комбинация тиотепы с мелфаланом. Все больные в посттрансплантационный период получали подкожные инъекции Г-КСФ. Приживление трансплантата определяли по достижению абсолютного числа нейтрофилов 0,5 × 10 9 /л и более, тромбоцитов-20 × 10 9 /л и более. Результаты. Установлено, что предикторами большого количества клеток CD34 + в аутотрансплантате являются одна предшествующая схема индукционной терапии (p = 0,0315) и использование циклофосфамида в режиме мобилизации (р = 0,0001). Сроки приживления трансплантата определяются порядковым номером аутоТГСК и количеством перелитых клеток CD34 +. Укорочение сроков восстановления гемопоэза после второй ауто-ТГСК обусловлено значимым увеличением случаев с использованием схемы Mel140 (р = 0,001). Заключение. Качество аутотрансплантата и сроки его приживления у больных ММ определяются преимущественно эффективностью индукционной терапии, а также интенсивностью режима мобилизации ГСК. В связи с этим выбор интенсивности индукционной терапии и режима мобилизации должен быть адаптирован к конкретному больному, прогностическому варианту ММ, вероятности ответа на стандартные индукционные схемы и числу планируемых аутоТГСК.

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Poor Hemopoietic Stem Cell Mobilizers in Multiple Myeloma : A Single Institution Experience

Cited by 3 publications

References 24 publications

Risk Factors and Outcomes of Stem Cell Mobilization Failure in Multiple Myeloma Patients

Risk Factors and Outcomes of Stem Cell Mobilization Failure in Multiple Myeloma Patients

Reduced‐dose plerixafor as a mobilization strategy in autologous hematopoietic cell transplantation: a proof of concept study

Factors Associated with Efficient Harvesting and Engraftment of Auto-Transplants in Multiple Myeloma Patients

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