Stem cell mobilization in multiple myeloma: challenges, strategies, and current developments

Wei, Xiaolei; Wei, Yongqiang

doi:10.1007/s00277-023-05170-0

Cited by 9 publications

(8 citation statements)

References 120 publications

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“…These cells may be accounted as hematopoietic progenitor cells by the XN‐20 module, which leads to diagnostic inaccuracy. A resulting tumor cell contamination of the graft could be expected in those cases 22 . A possible future investigation might examine whether a tumor cell contamination of the graft results in a poorer correlation of XN‐20 HPC measurement and flow cytometry.…”

Section: Discussionmentioning

confidence: 99%

Comparison of peripheral blood automated hematopoietic progenitor cell count and flow cytometric CD34+ cell count

Hagenkötter,

Mika,

Ladigan‐Badura

et al. 2024

J of Clinical Apheresis

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BackgroundStem cell apheresis in the context of autologous stem cell transplantation requires an accurate cluster of differentiantion 34 (CD34+) count determined by flow cytometry as the current gold standard. Since flow cytometry is a personnel and time‐intensive diagnostic tool, automated stem cell enumeration may provide a promising alternative. Hence, this study aimed to compare automated hematopoietic progenitor enumeration carried out on a Sysmex XN‐20 module compared with conventional flow cytometric measurements.MethodsOne hundred forty‐three blood samples from 41 patients were included in this study. Correlation between the two methods was calculated over all samples, depending on leukocyte count and diagnosis.ResultsOverall, we found a high degree of correlation (r = 0.884). Furthermore, correlation was not impaired by elevated leukocyte counts (>10 000/μL, r = 0.860 vs <10 000/μL, r = 0.849; >20 000/μL, r = 0.843 vs <20 000/μL, r = 0.875). However, correlation was significantly impaired in patients with multiple myeloma (multiple myeloma r = 0.840 vs nonmyeloma r = 0.934).SummaryStem cell measurement carried out on the Sysmex XN‐20 module provides a significant correlation with flow cytometry and might be implemented in clinical practice. In clinical decision‐making, there was discrepancy of under 15% of cases. In multiple myeloma patients, XN‐20 should be used with caution.

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Section: Discussionmentioning

confidence: 99%

Comparison of peripheral blood automated hematopoietic progenitor cell count and flow cytometric CD34+ cell count

Hagenkötter,

Mika,

Ladigan‐Badura

et al. 2024

J of Clinical Apheresis

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“…Furthermore, auto-HSCT improved PFS, indicating its therapeutic status in newly diagnosed MM patients. 3 Besides, auto-HSCT is crucial for MM patients after transplantation, even if monoclonal antibody-containing regimens are used as induction therapy. 4 Furthermore, auto-HSCT is crucial for relapsed or primary refractory diffuse large B-cell lymphoma or high-grade B-cell lymphoma, refractory mantle cell lymphoma, and peripheral T-cell lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Factors Affecting Hematopoietic Stem Cell Mobilization Efficiency and Early Hematopoietic Reconstruction Indicators during Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation

Shi,

Duan,

2024

Glob Med Genet

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Purpose To analyze the factors affecting the mobilization efficiency of hematopoietic stem cells and hematopoietic reconstruction indicators during autologous peripheral hematopoietic stem cell transplantation. Methods The clinical data of 54 patients who underwent autologous peripheral blood hematopoietic stem cell mobilization and transplantation at Xuzhou Central Hospital from May 2016 to April 2023 were retrospectively analyzed. The gender, age, disease type, mobilization regimen, number of chemotherapy sessions, G-CSF (granulocyte colony-stimulating factor) dosage, and platelet number at the time of collection were also collected. Moreover, the relationship between these indicators with mobilization results and hematopoietic reconstruction was analyzed. Results Results showed that age, disease type, and number of collections were significantly related to the mobilization results (number of CD34+ hematopoietic stem cells). Furthermore, multivariate analysis showed that the number of collections was an independent factor affecting mobilization efficiency. Similarly, age, platelet value at the time of collection, CD34+ stem cell value during collection, white blood cell count, and number of chemotherapy times were significantly related to the time of megakaryocytic hematopoietic reconstruction. Multifactor analysis found that age and platelet count were independent factors affecting the reconstruction time of the megakaryocytic system. However, no factor was related to the time of granulocyte hematopoietic reconstruction. Conclusion Platelet count and age when collecting hematopoietic stem cells are closely related to megakaryocytic hematopoietic reconstruction and are key indicators of early hematopoietic reconstruction after autologous hematopoietic stem cell transplantation.

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“…In one prospective study, it was found that all patients treated with six cycles of lenalidomide-based triplet therapy were able to collect enough cells for autologous transplant without mobilization failure [25] . Another analysis found that induction therapy with up to six cycles of VRD and KRD did not lead to stem cell mobilization failure [26] . Further, relaxing requirements of induction cycles prior to transplant can facilitate easier communication and workflow with community physicians referring patients to distant transplant centers and allow ongoing deep remissions in patients prior to transplant, which, as above, has been shown to be beneficial.…”

Section: Optimal Timing Of Mobilizationmentioning

confidence: 99%

Optimal approach to stem cell mobilization in transplant-eligible multiple myeloma patients

Fitzsimons,

Hagen

2024

J Cancer Metastasis Treat

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Multiple myeloma is a neoplastic disorder of plasma cells typically afflicting older individuals. Despite significant improvements in induction therapy and outcomes for transplant-ineligible newly diagnosed multiple myeloma (NDMM) patients, autologous stem cell transplant (ASCT) remains the standard of care for consolidation in transplant-eligible NDMM. Consequently, the optimal approach to stem cell mobilization remains critical. In this manuscript, we outline key updates to stem cell mobilization in NDMM patients. We describe the optimal number of cycles of induction prior to mobilization, emphasizing the need to balance the benefit of achieving improved depth of response by giving additional cycles of pre-transplant induction with the impact on stem cell yields. Additionally, we review ideal timing between the end of induction and initiation of mobilization to facilitate both a minimization of time off therapy as well as better communication and work flow between community providers and transplant centers. We also review different stem cell mobilization regimens with and without upfront CXCR4 inhibitors to optimize stem cell yields while considering both clinical outcomes and cost of care. Finally, we review optimal yields of CD34+ hematopoietic stem cells to minimize toxicity for ASCT and also consider optional utilization of stem cells for both salvage second ASCT and stem cell boosts for poor marrow function.

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Stem cell mobilization in multiple myeloma: challenges, strategies, and current developments

Cited by 9 publications

References 120 publications

Comparison of peripheral blood automated hematopoietic progenitor cell count and flow cytometric CD34+ cell count

Comparison of peripheral blood automated hematopoietic progenitor cell count and flow cytometric CD34+ cell count

Analysis of Factors Affecting Hematopoietic Stem Cell Mobilization Efficiency and Early Hematopoietic Reconstruction Indicators during Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation

Optimal approach to stem cell mobilization in transplant-eligible multiple myeloma patients

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