Keywords
Mobilization
Large volume leukapheresis
How to Cite
Abstract
Hematopoietic stem cell transplantation (HSCT) autologous is a therapeutic alternative for patients with multiple myeloma and lymphoma. Its success depends on the number of mobilized progenitor cells, harvested and infused. Poor stem cell mobilizers patients fails to obtain an adequate number of cells with classical stimulation with granulocyte colony stimulating factor (G-CSF). Treatment with plerixafor can overcome this difficulty and avoid re-mobilizations. The aim of our study was to evaluate and describe the effectiveness and safety of mobilization with G-CSF and plerixafor with large volume leukapheresis in 71 poor mobilizers patients. This strategy achieved suitable values of CD34+ in peripheral blood in 100% of patients and stem cell harvest was obtained with a median of 4,6 (range, 3,4 - 6,2) x 106/ kg of CD34+ cells. The engraftment was adequate and the median post stem cell transplantation of neutrophils recovery > 500 / uL was 11 days (range, 10 - 11), and platelets recovery > 20.000 / uL was 13 days (range, 12 - 15). With G-CSF and plerixafor, it was possible to transplant poor mobilizer patients with good results.
References
Wuchter P, Ran D, Bruckner T y col. Poor mobilizationof hematopoietic stem cells-definitions, incidence, risk factors, and impact on outcome of autologous transplantation. Biol. Blood Marrow Transplant. 2010;16:490-499.
Olivieri A, Marchetti M, Lemoli R y col. Proposed definition of ‘poor mobilizer’ in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo Italiano Trapianto di Midollo Osseo. Bone Marrow Transplant. 2012;47:342-351.
Giralt S, Costa L, Schriber J y col. Optimizing autologous stem cell mobilization strategies to improve patient outcomes: consensus guidelines and recommendations. Biol Blood Marrow Transplant. 2014;20:295-308.
Fernyhough L, Buchan V, McArthur L y col. Relative recovery of haematopoietic stem cell products after cryogenic storage of up to 19 years. Bone Marrow Transplant. 2013;48:32-35.
McCullough J, Haley R, Clay M y col. Long-term storage of peripheral blood stem cells frozen and stored with a conventional liquid nitrogen technique compared with cells frozen and stored in a mechanical freezer. Transfusion. 2010;50:808-819.
Spurr E, Wiggins N, Marsden K y col. Cryopreserved human haematopoietic stem cells retain engraftmentpotential after extended (5–14 years) cryostorage. Cryobiology. 2002;44:210-217.
Harvey RD, Kaufman JL, Johnson HR y col. Temporal changes in plerixafor administration and hematopoietic stem cell mobilization efficacy: results of a prospective clinical trial in multiple myeloma. Biol. Blood Marrow Transplant. 2013;19:1393-1395.
Larochelle A, Krouse A, Metzger M y col. AMD3100 mobilizes hematopoietic stem cells with long-term repopulating capacity in nonhuman primates. Blood. 2006;107:3772-3778.
Varmavuo V, Mäntymaa P, Kuittinen T y col. Blood graft lymphocyte subsets after plerixafor injection in non-Hodgkin’s lymphoma patients mobilizing poorly with chemotherapy plus granulocyte-colony-stimulating factor. Transfusion. 2012;52:1785-1791.
Gazitt Y, Freytes CO, Akay C y col. Improved mobilization of peripheral blood CD34+ cells and dendritic cells by AMD3100 plus granulocyte-colony-stimulatingfactor in non-Hodgkin’s lymphoma patients. StemCells Dev. 2007;16:657-666.
Fruehauf S, Seeger T, Maier P y col. The CXCR4 antagonist AMD3100 releases a subset of G-CSF-primed peripheral blood progenitor cells with specific gene expression characteristics. Exp. Hematol. 2006;34:1052- 1059.
Hess DA, Bonde J, Craft TP y col. Human progenitor cells rapidly mobilized by AMD3100 repopulate NOD/ SCID mice with increased frequency in comparison to cells from the same donor mobilized by granulocyte colony stimulating factor. Biol. Blood Marrow Transplant. 2007;13:398-411.
Slater S. Plerixafor. J Adv Pract Oncol. 2012; 3: 49-54. 14. Hübel K. Mobilization and Collection of HSC. The EBMT Handbook Hematopoietic Stem Cell Transplantation and Cellular Therapies. E Carreras, C Dufour, M Mohty, N Kröger 2019, p 117-122. 7 th Edition, Springer, Cham (Zug).
Gasová Z, Marinov I, Vodvárková S y col. PBPC collection techniques: standard versus large volume leukapheresis (LVL) in donors and in patients. Transfus. Apher. Sci. 2005;32:167-176.
Haas R, Mohle R, Fruhauf S y col. Patient characteristics associated with successful mobilizing and autografting of peripheral blood progenitor cells in malignant lymphoma. Blood. 1994;83:3787-3794.
Ketterer N, Salles G, Raba M y col. High CD34+ cell counts decrease hematologic toxicity of autologous peripheral blood progenitor cell transplantation. Blood 1998;91:3148-3155.
Chen J, Burns K, Babic A y col. Donor body mass index is an important factor that affects peripheral blood progenitor cell yield in healthy donors after mobilization with granulocyte–colony-stimulating factor. Transfusion. 2014;54:203-210.
Cassens U, Barth IM, Baumann C y col. Factors affecting the efficacy of peripheral blood progenitor cells collections by large-volume leukaphereses with standardized processing volumes. Transfusion. 2004;44:1593-1602.
Ferraro F, Lymperi S, Méndez-Ferrer S y col. Diabetes impairs hematopoietic stem cell mobilization by altering niche function. Sci Transl Med. 2011;3:104ra101.
Livingston D, Motlagh D, Debelak J y col. Phase 2 study of intramyocardial injection of autologous CD34+ cells to treat subjects with refractory chronic myocardial ischemia (CMI): factors influencing mobilization and apheresis. Blood. 2009;114:3227.
Martin AP, Richards S, Haycox A y col. Evaluating the use of plerixafor in stem cell mobilisation - an economic analysis of the PHANTASTIC trial. J Clin Apher. 2016;31:434-442.
All material published in the journal HEMATOLOGÍA (electronic and print version) is transferred to the Argentinean Society of Hematology. In accordance with the copyright Act (Act 11 723), a copyright transfer form will be sent to the authors of approved works, which has to be signed by all the authors before its publication. Authors should keep a copy of the original since the journal is not responsible for damages or losses of the material that was submitted. Authors should send an electronic version to the email: revista@sah.org.ar