Background: Chemotherapy mobilization of BPC is frequently used in patients who fail to reach the target CD34+ cell dose after mobilization with hematopoietic growth factors. We explored the use of paclitaxel for BPC mobilization in this population of patients. Methods: Eleven patients underwent mobilization, 8 adults and 3 children. Nine patients had previously failed mobilization with TBO-GCSF/Plerixafor. All received paclitaxel 250 mg/m 2 IV on Day 1. TBO-GCSF 10 mcg/kg SQ was given since day 2 and daily plerixafor .24 mg/kg SQ from Day 7 or 8 if the peripheral blood (PB) CD34+ was less than 5 cells/ul. Daily harvest by apheresis was started on Day 8 or 9 until the target CD34+ number was reached. One patient with a germ cell tumor, had ifosfamide administered with the paclitaxel. Results: Enough stem cells were harvested to proceed with transplantation in all 11 patients. Ten out of the 11 patients 176
Background: Aautologous hematopoietic stem cell transplants (HSCT) is the standard of care for newly diagnosed patients with multiple myeloma (MM) who are eligible for autologous transplantation. Although cryopreservation is routinely employed, autologous HSCT can be performed using non-cryopreserved stem cells. Methods and materials: A retrospective study of patients with MM who received autologous HSCT between the 10th of October 2010 and the 31st of January 2022 at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia was performed. Results: Over 11 years and 113 days, a total of 135 autologous HSCTs were performed for 119 patients with MM at our institution. Single autologous HSCTs were performed for 119 patients, while 16 of these patients received either planned tandem autologous transplants or second autografts due to either progression or relapse of their myeloma. The median age of patients with MM at autologous HSCT was 51.5 years. At presentation of their MM, the following high-risk (HR) features were encountered: stage III disease according to the revised international scoring system (RISS) in 12.3%; adverse cytogenetics in 31.93% of patients; advanced bone disease in 60.50%; and renal dysfunction or failure in 11.76% of patients. A total of 104 autologous HSCTs (77.04%) were performed without cryopreservation while 31 autografts (22.96%) were performed using cryopreserved apheresis stem cell products. Additionally, 54 autologous HSCTs (40.00%) were done at outpatient while 81 autografts (60.00%) were performed in an inpatient setting. Survival for 100 days post-HSCT for all patients with MM who received autologous transplants including those done at outpatient was 100%. The 4 years overall survival (OS) an progression-free survival (PFS) for patients with MM who received non- cryopreserved or fresh autologous HSCTs were 82% and 68% respectively. Conclusion: Autologous HSCT without cryopreservation is safe, and feasible and can lead to short-term as well as long-term outcomes that are comparable to autologous transplantation with cryopreservation. Non- cryopreserved autologous grafts allow the performance of autologous transplants in an outpatient setting to save beds and reduce costs.
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