Poor peripheral blood stem cell mobilization affects long‐term outcomes in multiple myeloma patients undergoing autologous stem cell transplantation

Moreb, Jan S.; Byrne, Michael; Shugarman, Ilicia L.; Zou, Fei; Xiong, Shaojun; May, W. Stratford; Norkin, Maxim; Hiemenz, John W.; Brown, Randall W.; Cogle, Christopher R.; Wingard, John R.; Hsu, Jack W.

doi:10.1002/jca.21556

Cited by 34 publications

(37 citation statements)

References 37 publications

(74 reference statements)

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“…Radiation exposure did not correlate with HPC collection which may be due to the small proportion of patients in our cohort who underwent radiation as well the heterogeneity of the cohort. A similar finding was reported by Moreb et al who restricted their study to myeloma patients only . The impact of BMI on HPC mobilization and collection remains unclear and available data are scarce.…”

Section: Discussionsupporting

confidence: 85%

“…Our study did not show a correlation between BMI and HPC collection yield in a large cohort of patients with various hematologic malignancies. Moreb et al reported an association between higher ideal body weight and poor mobilization; however, this was not reproducible upon multivariate analysis . Another study looked at HPC collection yield in volunteer donors mobilized with G‐CSF and found that higher BMI positively correlated with day 1 collection yield .…”

Section: Discussionmentioning

confidence: 99%

“…The adipose compartment contains hematopoietic stem cells, lymphocytes and other hematopoietic cells that may be pertinent to transplant biology and kinetics . Understanding the factors resulting in decreased HPC mobilization is of major importance given the associated worse long‐term transplant outcomes . Our study's principal aim was to characterize the impact of BMI on HPC mobilization.…”

Section: Discussionmentioning

confidence: 99%

“…8,19,21,22 Understanding the factors resulting in decreased HPC mobilization is of major importance given the associated worse long-term transplant outcomes. 15,23 Our study's principal aim was to characterize the impact of BMI on HPC mobilization. Patient characteristics leading to poor HPC mobilization have been described and include extensive prior therapy, age greater than 60 years, thrombocytopenia, prior radiation therapy and prior lenalidomide therapy.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13] Several factors leading to poor peripheral blood hematopoietic progenitor cell (HPC) mobilization have been reported. [14][15][16][17][18] A potentially significant, yet understudied factor is obesity, which may have a bearing on HPC mobilization via its effect on the interaction of the hematopoietic stem cell niche and its microenvironment, the need for a higher CD34+ cell dose based on actual body weight and alteration of mobilization agent pharmacokinetics. 8 We present herein the results of a single-institution study aiming at determining the effect of obesity on HPC mobilization and transplant outcomes that may be associated with cell dose in AHCT patients.…”

Section: Introductionmentioning

confidence: 99%

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Body mass index does not impact hematopoietic progenitor cell mobilization for autologous hematopoietic cell transplantation

Khouri

Rybicki

Majhail

et al. 2019

J of Clinical Apheresis

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Background Obesity has implications for hematopoietic progenitor cell (HPC) mobilization, chemotherapy administration, and medication dosing. We analyzed the impact of obesity on HPC mobilization as well as key outcomes that are associated with cell dose in autologous hematopoietic cell transplantation (AHCT) recipients. Methods We conducted a retrospective cohort study on 556 consecutive eligible AHCT recipients at our institution from 1/2004 to 12/2009. Patients were categorized into four groups based on the body mass index (BMI): underweight (BMI < 18.5), normal (18.5‐24.9), overweight (25.0‐29.9), or obese (≥30.0). Primary endpoints of interest included HPC mobilization, neutrophil and platelet recovery, hospital stay and survival. Results The diagnoses were mostly non‐Hodgkin lymphoma, multiple myeloma, and Hodgkin lymphoma. The majority of the patients had received three or less prior chemotherapy regimens and had not received prior radiation therapy. Most patients had chemosensitive disease at time of transplant. For HPC mobilization regimen, 68% received chemotherapy and G‐CSF, 32% received G‐CSF alone. Busuflan/etoposide/cyclophosphamide, melphalan, and busulfan/cyclophosphamide were used for conditioning. Obesity did not correlate with HPC mobilization and had no association with neutrophil or platelet recovery, or length of transplant hospitalization. On multivariable analysis, obese patients demonstrated better survival than those who were not obese. Conclusion Obese AHCT recipients had similar rates of HPC mobilization, neutrophil and platelet engraftment and length of transplant hospitalization, and experienced better survival compared with recipients with lower BMI. High BMI by itself should not be considered as a contraindication to AHCT.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Body mass index does not impact hematopoietic progenitor cell mobilization for autologous hematopoietic cell transplantation

Khouri

Rybicki

Majhail

et al. 2019

J of Clinical Apheresis

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Clinical outcomes of multiple myeloma patients who undergo autologous hematopoietic stem cell transplant with G‐CSF or G‐CSF and plerixafor mobilized grafts

et al. 2019

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Impact of Plerixafor (P) mobilized stem cells on immune reconstitution, such as absolute lymphocyte count at day 30 (ALC30), and on long-term outcomes of Multiple Myeloma (MM) patients undergoing autologous stem cell transplant (ASCT) has not been well established. We evaluated total of 469 patients mobilized with G-CSF (G) alone, and 141 patients mobilized with G-CSF plus plerixafor (G+ P). Patients only received plerixafor if they had peripheral blood CD34 + blood count <20/μL on first planned day of collection. Primary endpoint, ALC30, was 1.3 K/μL (range, 0.1-4.5) and 1.2 K/μL (range, 0.1-5.1) for G and G + P, respectively (P =. 61). The median PFS was 2.5 years (95% CI, 2.1-3.2) and 2.8 years (95% CI, 2.0-3.3) for G and G + P, respectively (HR: 1.13; 95% CI, 0.84-1.50; P = .42). The median OS was 6.1 years (95% CI, 4.6-NR) for G group compared to 3.7 years (95% CI, 3.2-NR) for the G + P group (HR: 1.64; 95% CI, 1.12-2.40; P = .01). The median follow-up time for OS was 2.53 years (95% CI, 2.13-2.99) and 1.59 years (95% CI, 1.17-2.02) for G and G+ P group, respectively. In this large retrospective analysis of MM patients mobilized with G-CSF vs G-CSF + P, there was no significant difference in lymphocyte recovery or PFS. There was an overall survival difference in patients who were poor mobilizers and could not be mobilized with G-CSF alone.

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Is absence of CD56 a predictive factor for peripheral blood stem cell mobilization failure in patients with multiple myeloma?

Göçer

Kurtoğlu

2020

J of Clinical Apheresis

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Background CD56 is believed to play a major role in MM pathogenesis with a 70% to 80% expression rate in malignant plasma cells at the time of diagnosis. Our objective in this study was to investigate the relationship between the characteristics of CD56 expression in bone marrow aspiration material at the time of diagnosis and the success of stem cell mobilization in patients diagnosed with MM. Methods This monocenter study included 94 patients who were diagnosed with MM and had a stem cell mobilization procedure for autologous hematopoietic stem cell transplantation. The primary endpoint of the study was to compare the mobilization success between the groups with and without CD56 expression. The secondary endpoint was to identify other factors affecting mobilization failure outside CD56. Results At the time of diagnosis, 49 (52.1%) patients had CD56 expression and 45 (47.9%) did not. Mobilization failed in 11 (11.7%) patients. Age, gender, ISS stage and the number of premobilization treatment regimens were not found predictive of mobilization failure. CD56 negativity was 42.2% in the group that had mobilization success and 90.9% in the group that had mobilization failure (P = .001). Conclusions The fact that CD56 residing on the membrane enables interaction between bone marrow cells and ECM and functions as a signal molecule increases sensitivity to the chemotherapy and G‐CSF that are used for mobilization. We found that absence of CD56 can be used as a predictive factor for mobilization failure at the time of diagnosis.

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Poor peripheral blood stem cell mobilization affects long‐term outcomes in multiple myeloma patients undergoing autologous stem cell transplantation

Cited by 34 publications

References 37 publications

Body mass index does not impact hematopoietic progenitor cell mobilization for autologous hematopoietic cell transplantation

Body mass index does not impact hematopoietic progenitor cell mobilization for autologous hematopoietic cell transplantation

Clinical outcomes of multiple myeloma patients who undergo autologous hematopoietic stem cell transplant with G‐CSF or G‐CSF and plerixafor mobilized grafts

Is absence of CD56 a predictive factor for peripheral blood stem cell mobilization failure in patients with multiple myeloma?

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