Similar dynamics of intraapheresis autologous <scp>CD</scp>34+ recruitment and collection efficiency in patients undergoing mobilization with or without plerixafor

Schade, Henning; Chhabra, Saurabh; Kang, Yubin; Stuart, Robert K.; Edwards, Kathy; Kramer, Cindy; Butcher, Coleen; Littleton, Amanda; Schneider, Molly; Budisavljevic, Milos N.; Costa, Luciano J.

doi:10.1111/trf.12761

Cited by 4 publications

(4 citation statements)

References 28 publications

(40 reference statements)

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“…To optimize CD34 + stem cell yields, many investigators have attempted to look at factors associated with CE that may be adjusted to improve mobilization success [42,43]. However, there is significant variability in the how CE is measured and reported across studies, and there are no uniform precollection recommendations to optimize CE.…”

Section: Discussionmentioning

confidence: 99%

Impact of Plerixafor Use at Different Peripheral Blood CD34+ Thresholds on Autologous Stem Cell Collection in Patients with Multiple Myeloma

Shah

Young

Wong

et al. 2020

Biology of Blood and Marrow Transplantation

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Patients with multiple myeloma (MM) scheduled for autologous stem cell transplantation must undergo autologous stem cell mobilization; unfortunately, however, many do not obtain an adequate collection yield. Despite the availability of plerixafor, its widespread and uniform use is limited by its cost, and consequently, many institutions have adopted various risk-adapted algorithms. We report our mobilization experience as we have modified our plerixafor algorithm to a more liberal one, with the expectation of greater collection efficiency and mobilization success with higher plerixafor use. A total of 344 mobilization attempts were analyzed over 3 time periods and using 3 different peripheral blood CD34 + cell counts to guide plerixafor use: <15/mL (n = 66), <20/mL (n = 130), and <40/mL (n = 148). The primary endpoints were evaluation of changes in mean plerixafor utilization and apheresis days and assessment of the impact on overall mobilization costs. Secondary endpoints were a description of the impact of lenalidomide use on mobilization and evaluation of the rate of mobilization failure. We found that mean plerixafor use increased from 1.32 to 1.65 to 1.74 doses per mobilization (P = .026) and the mean days of apheresis decreased from 2.15 to 2.17 to 1.89 days per mobilization for the <15/mL, <20/mL, and <40/mL cohorts, respectively (P = .011). The combined cost of plerixafor and apheresis procedures at a threshold of 40/mL is close to that at a threshold of 15/mL, while saving 26 apheresis days per 100 patients. In general, there were low rates of mobilization failure across all thresholds. Patients who received more than 6 cycles of lenalidomide demonstrated impaired mobilization and required more apheresis sessions (P < .013) and greater plerixafor use (P < .001) to achieve target stem cell yields. Overall, using plerixafor in patients with MM, with a day 4 pCD34 count of <40/mL is a reasonable and cost-effective strategy to optimize apheresis utilization.

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Section: Discussionmentioning

confidence: 99%

Impact of Plerixafor Use at Different Peripheral Blood CD34+ Thresholds on Autologous Stem Cell Collection in Patients with Multiple Myeloma

Shah

Young

Wong

et al. 2020

Biology of Blood and Marrow Transplantation

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“…The intra-apheresis recruited pool of CD34 + cells (iarHSC) has been calculated as shown in Equation 1. 16 Other IAR analyses, such as recruitment factor and recruitment coefficient, are not discussed here.…”

Section: Classical Calculations Of Iar and Cementioning

confidence: 99%

“…However, only the contributions of both peripheral blood and the apheresis system can be quantified because representative samples can be analyzed from both of these sources. The intra‐apheresis recruited pool of CD34 + cells (iarHSC) has been calculated as shown in Equation 16 . Other IAR analyses, such as recruitment factor and recruitment coefficient, are not discussed here.

iarHSC = yHSC + posHSC - preHSC

preHSC : Pre‐apheresis pool of CD34 + cells, posHSC : post‐apheresis pool of CD34 + cells, iarHSC : intra‐apheresis recruited pool of CD34 + cells, yHSC : yield, collected pool of CD34 + cells.…”

Section: Classical Calculations Of Iar and Cementioning

confidence: 99%

“…IAR may be related to the release of endogenous cytokines that might act synergistically with exogenously administered cytokines 7,9 . However, there are debates surrounding the mobilizing property of apheresis procedures 16,17 Mobilizer agents: The effects of mobilizer drugs can persist during the apheresis procedure, which can lead to IAR of HSCs, and the kinetics of such IAR is proportional to the HSCs count prior to apheresis 16 …”

Section: Toward Iarmentioning

confidence: 99%

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Crude collection efficiency of CD34⁺ hematopoietic stem cell apheresis

Castillo‐Aleman

2023

J of Clinical Apheresis

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Understanding the apheresis principles for harvesting hematopoietic stem cells (HSCs) is critical for performing efficient procedures. However, despite significant advances in estimating the collection efficiency (CE) of aphereses, many confounding factors still need to be addressed in the classical calculations. The CE values are unrestricted, and many procedures exhibit CEs of a given cell population greater than 100%. This report introduces a simple equation that estimates the “crude” CE, which ranges from 0% to 100% and intrinsically considers the contribution of donor‐related variables such as the pre‐procedure mobilization and intra‐apheresis recruitment of CD34+ cells (as a convenient marker for HSCs), as well as the performance of the apheresis system itself.

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Autologous Stem Cell Mobilization and Collection

Hsu

Cushing

2016

Hematology/Oncology Clinics of North America

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Similar dynamics of intraapheresis autologous CD34+ recruitment and collection efficiency in patients undergoing mobilization with or without plerixafor

Abstract: Kinetics of intraapheresis CD34+ recruitment and collection is proportional to PB-CD34+ but not influenced further by plerixafor.

Cited by 4 publications

References 28 publications

Impact of Plerixafor Use at Different Peripheral Blood CD34+ Thresholds on Autologous Stem Cell Collection in Patients with Multiple Myeloma

Impact of Plerixafor Use at Different Peripheral Blood CD34+ Thresholds on Autologous Stem Cell Collection in Patients with Multiple Myeloma

Crude collection efficiency of CD34⁺ hematopoietic stem cell apheresis

Autologous Stem Cell Mobilization and Collection

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Similar dynamics of intraapheresis autologous CD34+ recruitment and collection efficiency in patients undergoing mobilization with or without plerixafor

Abstract: Kinetics of intraapheresis CD34+ recruitment and collection is proportional to PB-CD34+ but not influenced further by plerixafor.

Cited by 4 publications

References 28 publications

Impact of Plerixafor Use at Different Peripheral Blood CD34+ Thresholds on Autologous Stem Cell Collection in Patients with Multiple Myeloma

Impact of Plerixafor Use at Different Peripheral Blood CD34+ Thresholds on Autologous Stem Cell Collection in Patients with Multiple Myeloma

Crude collection efficiency of CD34+ hematopoietic stem cell apheresis

Autologous Stem Cell Mobilization and Collection

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Product

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Crude collection efficiency of CD34⁺ hematopoietic stem cell apheresis