Mobilization, collection, and transplantation of peripheral blood hematopoietic progenitor cells in a patient with multiple myeloma and hemoglobin SC disease

Abstract

The results of this case demonstrate that erythrocytapheresis before high-dose G-CSF HPC mobilization and collection appears to be an effective means for prevention of vasoocclusive crisis in patients with hemoglobinopathies undergoing autologous stem cell transplantation.

Granulocyte colony-stimulating factor (G-CSF) administration in individuals with sickle cell disease: time for a moratorium?

“…One individual received G-CSF on two occasions; he experienced a VOC requiring hospitalization with prophylactic doses of G-CSF to prevent CIN, but tolerated subsequent G-CSF for autologous HSC mobilization without complications [4]. In total, 7 of the 11 individuals required hospitalization [1–5], while 4 others experienced no complications [5–7]. …”

“…Two others received simple red cell transfusion therapy, and one had back and extremity pain similar to prior VOC. In total, 3 of 4 patients in the red cell transfusion group [4–7], and 2 of 8 patients in the no transfusion group [1–5] were free of adverse events (again, one patient received G-CSF on two occasions). However, there was no threshold HbS under which VOC was prevented, as a patient with a HbS as low as 14.4% experienced VOC requiring hospitalization, and another patient with a HbS level of 75% did not have complications (Table I).…”

Difficulties in hematopoietic progenitor cell collection from a patient with TEMPI syndrome and severe iatrogenic iron deficiency

“…HPC‐A collections from patients with sickle cell trait were less efficient compared to normal controls and RBC removal from sickle cell trait products required ammonium chloride . A patient with multiple myeloma and sickle cell disease underwent prophylactic RBC exchange to reduce the number of abnormal RBCs before mobilization and collection . Interestingly, a recent publication described RBC interference during HPC‐A collection from a patient with multiple myeloma and β‐thalassemia intermedia .…”

“…19 A patient with multiple myeloma and sickle cell disease underwent prophylactic RBC exchange to reduce the number of abnormal RBCs before mobilization and collection. 20 Interestingly, a recent publication described RBC interference during HPC-A collection from a patient with multiple myeloma and b-thalassemia intermedia. 21 The microcytic, hypochromic RBCs in this thalassemic patient were not separable from the HPCs in the buffy coat but the patient was transplanted successfully without additional manipulation of the product and without reaction during or after infusion.…”

Harvesting autologous stem cells from a patient with red blood cell abnormalities of β‐thalassemia intermedia

“…Additionally, improved treatment modalities in this patient population have resulted in extended life spans but with a concomitant increased incidence of hematologic malignancies . A recent case report featured a patient with Hb SC disease who underwent an autologous stem cell transplant for MM . Survival in β‐thalassemia has also improved due to use of more effective iron chelation and even better monitoring with magnetic resonance imaging to guide cardiac care .…”