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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.

Treatment with IMiDs and/or PI pre-transplant was associated with better survival versus no prior exposure to these agents but this was not statistically significant (P = .11) (Figure 2). In this analysis, we show that a significant number of patients undergo delayed ASCT for MM. Outcomes of ASCT after L1 and L2 were similar. This being a retrospective study, we cannot asses the number of patients who intended to but were not able to undergo delayed ASCT. Exposure to one or both highly active anti-myeloma agents (IMids and PI) before ASCT was associated with better post transplant outcomes.

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BackgroundOptimization of platelet (PLT) apheresis collection is a priority to satisfy the increasing demand of hemato‐oncology patients. We assessed the performance of a plateletpheresis unit supporting hematology patients.Study design and methodsThis descriptive retrospective study included 561 plateletpheresis collections from 2013 to 2018. For data analysis, descriptive statistics and receiver operating characteristic (ROC) curve were used. A 5‐item satisfaction questionnaire was analyzed.ResultsNinety percent of the donors were males. The median plateletpheresis time was 89 minutes; its success rate was 92.5%; median donor PLT count was 232 × 109/L, women median PLT count was 247 × 109/L vs 231x109/L in men (P = .017). Seventy‐seven percent donors were candidates for a double product and 24.5% were processed; 20.8% of these donors had a weight ≤75 and 79.2% >75 kg, P = .003, and 6.6% were women and 93.4% men, P = .161. Thirty‐six of donors had ≥250 × 109/L and 16.8% was processed as a triple product. ROC analysis showed that with donor PLT counts ≥200 × 109/L the sensitivity for obtaining double products was 0.981 and specificity 0.714, with an area under the curve (AUC) = 0.877. The adverse effect rate was 4.3%. Of the potential donors, 6.3% were rejected. The cost of processing single or double products was 430 USD. Comfort and time spent during plateletpheresis were areas for improvement.ConclusionPlatelet count and donor weight predicted PLT yield and obtaining double products. Women had higher PLT counts, but no significant difference was found between donor gender and processed products. Assessment of the apheresis unit can help to improve its performance.

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