Scoring system for the prediction of successful peripheral blood stem cell (PBSC) collection in non-Hodgkin's lymphoma (NHL): application in clinical practice

Vantelon, JM; Koscielny, Serge; Brault, P; Bourhis, J.; Ribrag, Vincent; Pico, J L; Fenaux, Pierre; Jn, Munck

doi:10.1038/sj.bmt.1702201

Cited by 23 publications

(17 citation statements)

References 24 publications

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“…Overall, the patients were characterized by features that are known to affect standard stem cell mobilization negatively, including advanced age, a diagnosis of NHL, previous radiotherapy, extensive treatment with chemotherapy, treatment with lenalidomide or purine analogues, previous autoSCT, or failure of at least one previous attempt at mobilization [7][8][9][10][11][12][13][14][15]. We observed that, despite these unfavorable characteristics, mobilization with plerixafor and G-CSF enabled the required number of stem cells to be collected in 67.5% of patients.…”

Section: Discussionmentioning

confidence: 99%

Identification of prognostic factors for plerixafor‐based hematopoietic stem cell mobilization

et al. 2011

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The introduction of plerixafor has enabled successful collection of stem cells in the majority of patients with lymphoma or myeloma in whom previous attempts at mobilization have failed. However, a proportion of patients have been shown to be resistant to this mobilization regimen. To identify the factors that impair stem cell mobilization and collection with plerixafor, we reviewed the data for 197 patients who had undergone mobilization with plerixafor and granulocyte-colony stimulating factor in Central Europe. Predictors of mobilization failure were evaluated using logistic regression analysis. Among the 197 patients mobilized, the target of 2.0 3 10 6 CD341 cells/kg was collected from 133 (67.5%). Our analysis revealed that previous treatment with lenalidomide, bortezomib, melphalan, radiotherapy, or autologous stem cell transplantation and regimen of plerixafor use in combination with chemotherapy had no significant effect on the efficiency of collection. In contrast, an age 65 years (odds ratio 0.331, 95% CI: 0.112-0.977, P < 0.05), a diagnosis of non-Hodgkin's lymphoma (odds ratio 0.277, 95% CI: 0.124-0.622, P < 0.01), and treatment with four chemotherapy regimens (odds ratio 0.366, 95% CI: 0.167-0.799, P < 0.05) were associated significantly with failed mobilization. The rate of successful mobilizations was decreased in patients treated with purine analogues (odds ratio 0.323, 95% CI: 0.096-1.094, P 5 0.07) but increased in female patients (odds ratio 1.961, CI: 0.943-4.080, P 5 0.07). Patients who are characterized by the above negative features could benefit potentially from further improvement in the mobilization strategy. Am. J. Hematol. 86:550-553, 2011. V

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Section: Discussionmentioning

confidence: 99%

Identification of prognostic factors for plerixafor‐based hematopoietic stem cell mobilization

et al. 2011

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“…3,4,[16][17][18] Most studies have included patients with heterogeneous diagnoses, previous therapy and mobilisation regimens. Drake et al 4 proposed a scoring system for previous chemotherapy predicting mobilisation efficiency in a patient population consisting mostly of NHL, Hodgkin's lymphoma and multiple myeloma.…”

Section: Discussionmentioning

confidence: 99%

Is chemotherapy scoring useful to predict progenitor cell mobilisation in patients with non-Hodgkin's lymphoma?

Jantunen

Kuittinen

Nousiainen

2003

Bone Marrow Transplant

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Summary:About 10-30% of patients with non-Hodgkin's lymphoma (NHL) intended to receive high-dose therapy are difficult to mobilise. Damage to the stem cell pool caused by previous chemotherapy may be an important factor in predicting progenitor cell mobilisation. We have analysed associations between chemotherapy score and efficiency of progenitor cell mobilisation in 120 consecutive NHL patients mobilised with intermediate-dose cyclophosphamide (4 g/m 2 ) plus G-CSF. The original chemotherapy scoring system proposed by Drake et al was applicable in only 27% of our patients and was not predictive for mobilisation outcome. Therefore we made an improved scoring system for previous chemotherapy by adding new drugs. Altogether, 111 patients (93%) could be scored. Our chemotherapy score showed an inverse correlation with the peak blood CD34 + count measured after the mobilisation (r ¼ À0.214, P ¼ 0.024) and with the number of CD34 + cells collected (r ¼ À0.234, P ¼ 0.02). However, in the receiver operating characteristics curve, no threshold value could be detected for chemotherapy score predicting mobilisation failure. Thus, both the original scoring system as well as our more widely applicable scoring system seem to be of limited value in predicting progenitor cell mobilisation in patients with NHL.

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“…Consistent with other reports, the cumulative myelotoxicity of the drugs previously administered to patients over their disease course seemed to play a role in jeopardizing the yield after mobilization. [18][19][20] According to the phase of the disease, patients with ANLL in CR1, who are less heavily treated, were 'better mobilizers', as compared to patients with ALL in CR2, while patients with ALL in CR3 did not mobilize at all. Moreover, the longer the treatment phase before mobilization, the lower the yield for ANLL patients in CR1.…”

Section: Discussionmentioning

confidence: 99%

Peripheral blood stem cell collection in children with acute leukemia: effectiveness of the ‘DIAVE’ mobilizing regimen

Balduzzi

Perseghin

Dassi

et al. 2002

Bone Marrow Transplant

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Summary:Few experiences of peripheral blood (PB) hematopoietic stem cell mobilization for autologous transplantation have been reported to date in children with acute leukemia (AL). The five-drug-chemotherapy 'DIAVE' (dexamethazone, idarubicine, cytosine-arabinoside, vincristine, etoposide), followed by G-CSF, previously reported as consolidation, was adopted as a mobilization regimen in 29 children (median age: 8 years, range: 3-21; median weight: 34 kg, range: 15-73) with ALL in second remission (CR2: 21), in CR3 (2) or ANLL in CR1 (6). A median peak of 94 ؋ 10 6 CD34 + cells/l (range: 10-604) was reached at a median time of 12 days (range: 10-18) after the beginning of the mobilizing regimen, which was well tolerated. A median of 10.9 ؋ 10 6 CD34 + cells/kg (range: 2.4-56.6) were collected in 25 patients (86%), approaching 40 ؋ 10 6 /l CD34 + cells in the PB (ALL in CR2: 20/21, in CR3: 0/2; ANLL: 5/6) by means of one (20) or two (5) leukaphereses; a median of 2.5 blood volumes was processed. Patients with ANLL mobilized more cells than patients with ALL; moreover, the shorter the interval between remission and mobilizing therapy, the higher was the yield. The products collected underwent purification, aiming at achieving complete removal of possibly contaminating leukemic cells, in 21 cases; also, unmanipulated aliquots were stored as rescues for all but one patient. All the 23 patients undergoing transplantation engrafted (ANC Ͼ0.5 ؋ 10 9 /l) at a median of 12 days. In conclusion, the DIAVE regimen compares favorably with conventional mobilizing regimens, usually containing cyclophosphamide, in terms of low toxicity, collection time predictability, and efficacy, as shown by the high proportion of patients mobilizing, the large amounts of stem cell collected by means of one or two leukaphereses only, and the prompt engraftment after infusion.

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Scoring system for the prediction of successful peripheral blood stem cell (PBSC) collection in non-Hodgkin's lymphoma (NHL): application in clinical practice

Cited by 23 publications

References 24 publications

Identification of prognostic factors for plerixafor‐based hematopoietic stem cell mobilization

Identification of prognostic factors for plerixafor‐based hematopoietic stem cell mobilization

Is chemotherapy scoring useful to predict progenitor cell mobilisation in patients with non-Hodgkin's lymphoma?

Peripheral blood stem cell collection in children with acute leukemia: effectiveness of the ‘DIAVE’ mobilizing regimen

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