Large‐volume‐apheresis facilitates autologous transplantation of hematopoietic progenitors in poor mobilizer patients

Majado, Maria Juliana; Minguela, Alfredo; González-García, Consuelo; Salido, Eduardo; Blanquer, Miguel; Funes, C; Insausti, Carmen L; García-Hernández, Ana M; Moraleda, José Marı́a; Morales, Alfonso

doi:10.1002/jca.20191

Cited by 22 publications

(22 citation statements)

References 42 publications

(76 reference statements)

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“…It is important to emphasize that in spite of decrease of peripheral blood CD34+ cell count during LVL, the total cumulative CD34+ cell yield increased steadily after each blood volume processed. Kinetics of CD34+ cell collection were similar and stable regardless of diagnosis or level of CD34+ cell mobilization, therefore all patients could have benefit from LVL [32].…”

Section: Discussionmentioning

confidence: 88%

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Bojanić

Dubravčić

Batinić

et al. 2011

Transfusion and Apheresis Science

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Section: Discussionmentioning

confidence: 88%

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Bojanić

Dubravčić

Batinić

et al. 2011

Transfusion and Apheresis Science

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“…It was already shown that large-volume leukaphereses (LVL) may result in an intra-apheresis recruitment of CD34+ cells in the range of up to 3.5 × 10 6 CD34+ cells/kg bw, therefore representing an additional tool for improving the yield in poor or non-optimally mobilizing patients [19,20,21,22]. …”

Section: Introductionmentioning

confidence: 99%

Successful Mobilization, Intra-Apheresis Recruitment, and Harvest of Hematopoietic Progenitor Cells by Addition of Plerixafor and Subsequent Large-Volume Leukapheresis

Humpe

Buwitt-Beckmann²,

Schub³

et al. 2013

Transfus Med Hemother

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Background: In patients failing successful conventional mobilization of hematopoietic progenitor cells (HPC) plerixafor (Mozobil®) seems to be an alternative. We report a series of 14 patients with multiple myeloma or NHL successfully mobilized and harvested by plerixafor together with large-volume leukaphereses (LVL). Methods: In a first series (GI), 5 patients were mobilized with G-CSF and plerixafor. In the second series (GII), 9 patients were mobilized by chemotherapy, G-CSF, and plerixafor. Results: In GI and GII, addition of plerixafor led to a significant (p < 0.01) increase of leukocytes and CD34+ cells in peripheral blood (PB). In GII, the median number of CD34+ cells in PB before and after addition of plerixafor was significantly (p = 0.019) higher compared to GI (9 vs. 5 and 50 vs. 24 cells/µl, respectively). In GI and GII, a median number of three or one aphereses was performed. In GII, the median yield (6.7 × 10⁶ CD34+ cells/kg) of the first apheresis and the median intra-apheresis recruitment of CD34+ cells were significantly (p < 0.05) higher compared to GI (2.94 × 10⁶ CD34+ cells/kg). All patients transplanted, 5 in GI and 8 in GII, exhibited successful engraftment. Conclusions: Plerixafor and G-CSF mobilization or the addition of plerixafor during non-optimal chemotherapy and G-CSF mobilization together with LVL enabled, independent of leukocyte count and even without detectable CD34+ cells before addition of plerixafor, sufficient harvest of HPC numbers for transplantation. Addition of plerixafor during chemotherapy and G-CSF mobilization led to an increased intra-apheresis recruitment and a significantly higher yield of CD34+ cells compared to plerixafor and G-CSF steady-state mobilized patients.

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“…Although the peripheral blood CD341 cell quantification before collection can be used to predict yield, many transplant centers do no employ this method for a variety of reasons, including increased cost and slow return of results precluding same day apheresis [10][11][12][13]. The purpose of this retrospective analysis was to determine if CD341 cell collection quantity in the first day or first two days of aphereses could reliably predict the likelihood of failure to collect sufficient CD341 cells for ASCT in patients with multiple myeloma.…”

Section: Introductionmentioning

confidence: 99%

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

Duong

Bolwell

Rybicki

et al. 2011

J of Clinical Apheresis

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Early and reliable prediction of the likelihood of achieving adequate stem cell collection for autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM) would improve collection efficiency, prevent unnecessary aphereses, and permit appropriate treatment alterations. No previous study has reported a threshold CD34+ cell collection quantity on Day 1 or 2 of leukapheresis that could predict successful stem cell collection. We performed a retrospective analysis of all MM patients undergoing first attempt of stem cell collection at our institution from 2001 through 2008. Recursive partitioning analysis was used to identify Day 1 or Day 1+2 CD34+ collection quantity that predicted failure to reach target ≥ 2 × 10(6) CD34+ cells/kg within five days of collection. Totally, 172 patients were included in the analysis. Patients underwent mobilization with G-CSF or G-CSF+ chemotherapy. 23 of 172 patients (13.4%) failed to collect sufficient (≥ 2 × 10(6) CD34+ cells/kg) CD34+ cells after five days of apheresis: 22 of 29 who collected ≤ 0.70 × 10(6) CD34+ cells/kg and 1 of 143 who collected > 0.70 × 10(6) CD34+ cells/kg (75.9% vs. 0.7%, P < 0.001) on Day 1. Collection failure occurred in 23 of 30 patients who collected ≤ 1.54 × 10(6) CD34+ cells/kg and 0 of 142 who collected >1.54 × 10(6) CD34+ cells/kg (76.7% vs. 0%, P < 0.001) on Days 1 + 2. Day 1 CD34+ cell collection quantity identifies patients unlikely to achieve adequate collection for ASCT. Patients who collect ≤ 0.70 × 10(6) CD34+ cells/kg on day 1 could be considered for treatment modifications to improve CD34+ collection, such as early administration of plerixafor or large volume apheresis.

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Large‐volume‐apheresis facilitates autologous transplantation of hematopoietic progenitors in poor mobilizer patients

Cited by 22 publications

References 42 publications

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Successful Mobilization, Intra-Apheresis Recruitment, and Harvest of Hematopoietic Progenitor Cells by Addition of Plerixafor and Subsequent Large-Volume Leukapheresis

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

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