Management of poor peripheral blood stem cell mobilization: Incidence, predictive factors, alternative strategies and outcome. A retrospective analysis on 2177 patients from three major Italian institutions

Perseghin, Paolo; Terruzzi, Elisabetta; Dassi, Maria; Baldini, Valentina; Parma, Matteo; Coluccia, Paola; Accorsi, Patrizia; Confalonieri, G; Tavecchia, Luisa; Verga, Luisa; Ravagnani, Fernando; Iacone, A; Pogliani, E; Pioltelli, Pietro

doi:10.1016/j.transci.2009.05.011

Cited by 82 publications

(71 citation statements)

References 26 publications

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“…Reports indicate that 5% to 46% of patients undergoing an initial mobilization attempt fail to achieve adequate CD341 cells for transplantation [6,7,15]. Of those patients who fail initial mobilization, second mobilization is unsuccessful in 20-40% [6][7][8][9]. Pusic et al reported that only 70% of remobilized patients were able to collect 2 3 10 6 CD341 cells/ kg when the number of cells from both first and second collection attempts were combined.…”

Section: Discussionmentioning

confidence: 99%

“…Current mobilization regimens yield inadequate CD341 cell doses in 5-46% of patients [6,7]. Factors which adversely influence collection of CD341 cells include extensive marrow involvement with malignancy, prior radiotherapy, prior treatment with alkylating agents, multiple chemotherapy regimens, and older age [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Factors which adversely influence collection of CD341 cells include extensive marrow involvement with malignancy, prior radiotherapy, prior treatment with alkylating agents, multiple chemotherapy regimens, and older age [6][7][8][9]. Chemotherapeutic agents associated with poor stem cell mobilization include melphalan, nitrosoureas, nitrogen mustard, procarbazine, platinum compounds, and lenalidomide.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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show abstract

“…43 In a multicenter analysis, age, sex, diagnosis, prior chemotherapy regimens, cumulative alkylator dose, precollection infections, and time from last chemotherapy were all predictive of yield. 44 In our transplant cohort, remobilization strategies differed on the basis of the underlying disease. In multiple myeloma, patients with poor collections immediately received CY pulsing to enhance yield.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

Gertz

Wolf

Micallef

et al. 2010

Bone Marrow Transplant

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“…Another issue is the lack of information about the total number of chemotherapy cycles and the agents used before mobilization. Prolonged chemotherapy treatment and alkylating agents have been reported as predictive factors associated with poor HSC yields (8,19,(22)(23)(24) .…”

Section: Discussionmentioning

confidence: 99%

Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience

Sakashita

Kondo

Ribeiro

et al. 2011

Einstein (São Paulo)

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Objective: To evaluate factors affecting peripheral blood hematopoietic stem cell yield in patients undergoing large-volume leukapheresis for autologous peripheral blood stem cell collection. Methods: Data from 304 consecutive autologous peripheral blood stem cell donors mobilized with hematopoietic growth factor (usually G-CSF), associated or not with chemotherapy, at Hospital Israelita Albert Einstein between February 1999 and June 2010 were retrospectively analyzed. The objective was to obtain at least 2 × 106 CD34+ cells/kg of body weight. Pre-mobilization factors analyzed included patient's age, gender and diagnosis. Post mobilization parameters evaluated were pre-apheresis peripheral white blood cell count, immature circulating cell count, mononuclear cell count, peripheral blood CD34+ cell count, platelet count, and hemoglobin level. The effect of pre and post-mobilization factors on hematopoietic stem cell collection yield was investigated using logistic regression analysis (univariate and multivariate approaches). Results: Pre-mobilization factors correlating to poor CD34 + cell yield in univariate analysis were acute myeloid leukemia (p = 0.017) and other hematological diseases (p = 0.023). Significant post-mobilization factors included peripheral blood immature circulating cells (p = 0.001), granulocytes (p = 0.002), hemoglobin level (p = 0.016), and CD34+ cell concentration (p < 0.001) in the first harvesting day. However, according to multivariate analysis, peripheral blood CD34+ cell content (p < 0.001) was the only independent factor that significantly correlated to poor hematopoietic stem cell yield. Conclusion: In this study, peripheral blood CD34+ cell concentration was the only factor significantly correlated to yield in patients submitted to for autologous collection.

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Management of poor peripheral blood stem cell mobilization: Incidence, predictive factors, alternative strategies and outcome. A retrospective analysis on 2177 patients from three major Italian institutions

Cited by 82 publications

References 26 publications

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

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

Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience

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