Stem Cell Mobilization and Harvesting Failure in Case of Heavily Pretreated Patients

Abstract

Background: High-dose chemotherapy and autologous stem cell transplantation have become a standard curative treatment in various hematologic malignancies. Many factors can affect the success of mobilization and hematopoietic stem cell harvesting. Aim: The aim of this study was to analyze factors that lead to mobilization failure. Material and Methods: We conducted a retrospective study on 19 patients with failure of stem cell harvesting. All patients were administered high doses of GCS-F (filgrastim, 15 μg/kg/day) and 0.24 mg/kg of plerixafor on day +5 or +10 of harvesting. Results: The median age of the study population was 51 years (range 35-67) and 52.6% (n = 10) were males. The study group included 4 (21%) subjects with multiple myeloma, 6 (31.5%) with Hodgkin lymphoma, 8 cases (42.1%) with nonHodgkin lymphoma and 1 patient with chronic lymphocytic leukemia. Each patient received 2.78 (range 1-5) lines of chemotherapy, administered in 11.57 (range 2 to over 20) cycles of treatment. Conclusion: In hematologic malignancies it is very important to collect stem cells in time, in order to reduce mobilization failure. As we have shown in our studied cases, multiple lines of polychemotherapy with or without radiotherapy lead to mobilization failure.

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“…Moreover, the study included patients with various types of hematological malignancies, and the results found that the highest mobilization failure occurred in non-Hodgkin lymphoma (42%, n = 8), Hodgkin lymphoma (37.5%, n = 6), and multiple myeloma (21%, n = 4). 15 Being that autologous stem cell therapies can be a curative option for patients with various hematological cancers, further studies on the cause and factors associated with failure to harvest stem cells, as well as methods for improvement are essential.…”