Poor stem cell mobilisers - variation in response to G-CSF dose escalation

Morris, T. C. M.; Ranaghan, L.; Drake, Mary

doi:10.1038/sj.bmt.1701929

Cited by 2 publications

(2 citation statements)

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“…The median number of CD34 cells/kg infused were 7.29 × 10 6 (range 4.63-28.10). The median day to reaching ANC ≥500 was 12 days (range [10][11][12][13][14][15][16][17][18][19] in absence of G-CSF support and platelets ≥20K was 11 days (range 0-19) and platelets count ≥50K was 16.5 days range 11-42 days. There was no primary or secondary graft failures post ASCT.…”

Section: Response To Therapymentioning

confidence: 99%

“…Patients are considered "poor mobilizers" if they do not collect 2 × 10 6 CD34 cells/kg in a certain number of days of apheresis (e.g., 5 days or less) [8,10,11]. In the literature, up to 20% of NHL patients are reported to have a hard time initially mobilizing PBSC [8,[10][11][12]. Consequently, this may result in multiple attempts to collect stem cells with increased costs.…”

Section: Introductionmentioning

confidence: 99%

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Mobilization of Autologous Peripheral Blood Stem Cells (PBSC) in CD20+ Lymphoma Patients Using RICE, Granulocyte-Colony Stimulating Factor (G-CSF) and Plerixafor

Holmberg¹,

Linenberger²,

Connelly‐Smith³

2023

OBM Transplant

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RICE is salvage therapy for treating CD20+non-Hodgkin lymphoma (NHL). It is combined with G-CSF to collect autologous peripheral blood stem cells (aPBSC). Little data exists, though, on the combination of G-CSF and Plerixafor after RICE in mobilizing adequate number of CD34 cells and the product’s immune content. We report on the results of twenty CD20+ NHL patients after RICE, G-CSF and Plerixafor were given to collect aPBSC. The median number of cells collected was 12.92 × 10<sup>6</sup> CD34 cells/kg (range 5.44-83.76). Plerixafor toxicity included diarrhea (n = 5) and injection-site irritation (n = 1). Seventeen patients collected; fifteen patients did so in one session. Two patients with CLL/Richter or transformed follicular had positive-flow products. Addition of Plerixafor to G-CSF increased by 2.6-9 folds the number of blood CD34 cells. Sixteen patients went to ASCT, with a median of 7.29 × 10<sup>6</sup> CD34 cells/kg infused. The median engraftment time post-ASCT for neutrophils was 12 (range 10-19), for platelets ≥20K 11 (range 0-19) and ≥50K 16.5 (range 11-42) days. There were no graft failures. In APBSC product, there was no evidence of NK or LAK lytic activity (n = 10), only LAK activity (n = 4) and both LAK and NK activity (n = 2). Blood NK activity was common on day +28 post-ASCT. There was no significant correlation between apheresis product and the number of blood immune cells post- ASCT or relapse. Addition of Plerixafor to RICE/G-CSF is well tolerated. The majority of patients collected aPBSC in one session.

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