Who should be really considered as a poor mobilizer in the plerixafor era?

Andreola, Giovanna; Vanazzi, Anna; Radice, Davide; Babic, Ana; Rabascio, Cristina; Negri, Mara; Martinelli, Giovanni; Laszlò, Daniele

doi:10.1016/j.transci.2012.03.004

Cited by 11 publications

(9 citation statements)

References 36 publications

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“…We were able to demonstrate a high positive predictive value for the cutoff value of 20 CD34+ cells/μl for both minimal and target total mobilized CD34+ cells/kg, while the negative predictive value of 10 CD34+ cells/μl for both levels was less prominent. Of those who had counts <10/µl, 60% failed to collect the minimum stem cells (table 2), which is in line with several previously published reports showing that even in patients with low PB CD34+ levels (≤20/µl or ≤10/µl) a sufficient number of CD34+ cells can sometimes be collected [44,48,49]. Therefore, while some recent publications report a correlation between circulating PB CD34+ counts and the yield of mobilization [6,10,11,41], it is not fully clear what is the optimal preapheresis level of PB CD34+ cells/μl, and whether or not this level should be tailored to the collection.…”

Section: Discussionsupporting

confidence: 86%

“…Several studies considered a peak of CD34+ cells ≥20 µl in PB as a reliable indicator of satisfactory mobilization ability [3,10,11,12,13,14,15,16]. On the contrary, the studies of Andreola et al [44] showed that more than 70% of the patients with <20 PB CD34+ cells/μl collected the minimum number of 2.0 × 10 6 CD34+ cells/kg. Therefore, the exact level of PB CD34+ cells/µl that predicts poor mobilization with G-CSF is still not well established.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Plerixafor (Mozobil): A Stem Cell-Mobilizing Agent for Transplantation in Lymphoma Patients Predicted to Be Poor Mobilizers - A Pilot Study

et al. 2015

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Autologous hematopoietic stem cell transplantation is the standard therapy for refractory/relapsed aggressive lymphoma. The initial step of the procedure involves mobilization and collection of hematopoietic stem cells. G-CSF fails to achieve mobilization in 15-25% of lymphoma patients. Plerixafor is a novel CXCR4 antagonist that can promote mobilization. It has been used successfully in patients after the failure of G-CSF. It is reasonable to test whether plerixafor should become the mobilizing agent of choice in patients expected to exhibit difficulties in mobilization. We initiated a study to assess the use of plerixafor as a first-line stem cell mobilizer in 20 elderly or heavily pretreated patients with non-Hodgkin or Hodgkin lymphoma. The minimum defined CD34+ cell dose of ≥2 × 10⁶ cells/kg was achieved by 90% of the patients, and for 83% of them with one apheresis procedure. The target CD34+ dose of ≥5 × 10⁶ cells/kg was achieved by 70% of the patients. The median number of circulating CD34+ cells before and after plerixafor was 14.4 and 42.8 cells/μl, respectively. The post-plerixafor adverse events were mild. All patients promptly engrafted after high-dose chemotherapy treatment. We conclude that plerixafor administration is safe and efficient for upfront mobilization in lymphoma patients predicted to be poor mobilizers.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Plerixafor (Mozobil): A Stem Cell-Mobilizing Agent for Transplantation in Lymphoma Patients Predicted to Be Poor Mobilizers - A Pilot Study

et al. 2015

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“…After unsuccessful mobilization, the unfavorable situation can be quickly corrected by using plerixafor in a salvage administration. 65 , 91 The old devices gave the opportunity to improve the harvest manually, while new devices perform the task automatically. Another solution consists in processing more blood volumes during the apheresis sessions.…”

Section: Pb Hspc Harvesting By Apheresismentioning

confidence: 99%

Hematopoietic stem and progenitor cell harvesting: technical advances and clinical utility

Héquet¹

2015

JBM

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Hematopoietic stem and progenitor cell (HSPC) transplantations require prior harvesting of allogeneic or autologous HSPCs. HSPCs are usually present in bone marrow (BM) during the entire life, in cord blood (CB) at birth, or in peripheral blood (PB) under particular circumstances. HSPCs were first harvested in BM and later in CB and PB, as studies showed interesting features of such grafts. All harvesting methods were in use throughout the years, except BM harvesting for HSPC autologous transplantation, which was replaced by PB harvesting. BM, CB, and PB harvesting methods have been developed, and materials and devices technically improved to increase the number of HSPCs harvested. In parallel, knowing the features of the donors or patients associated with successful numbers of HSPCs allows the adaptation of appropriate harvesting methods. Moreover, it is important to ensure the safety of donors or patients while harvesting. This review describes the methods used for harvesting based on recent studies or developments around these methods, and more particularly, the means developed to increase the numbers of HSPCs harvested in each method. It also explains briefly the influence of technical improvements in HSPC harvesting on potential changes in HSPC graft composition.

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“…Procedures performed with the apheresis machine Cobe Spectra were further assessed with regard to apheresis regimen (Tabs 6 and 7), focusing subsequently on LVL performance in "poor-mobilizers", defi ned as subjects with low pre-run CD34+ cell count in peripheral blood, i.e. < 20×10 6 /L (3,15). Procedure and harvest characteristics are detailed in Table 8.…”

Section: Resultsmentioning

confidence: 99%

Collection of peripheral hematopoietic stem/progenitor cells

Vr¹,

Mistrík²,

Martinka³

et al. 2015

BLL

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Objectives: Several variables possibly affecting collection of peripheral hematopoietic stem/progenitor cells (PBSC) were evaluated: type of apheresis machine (Amicus version 2.5, Baxter vs Cobe Spectra version 7.0, Terumo BCT), venous access (peripheral vein vs central venous catheter, i.g. CVC), and apheresis regimen (standard vs large volume leukapheresis, i.g. SVL vs LVL) with the objective to increase collection effi cacy at the site. Background: Peripheral blood represents the currently preferred source of hematopoietic stem/progenitor cells (HSCs) for transplantation. Methods: Data regarding 169 collection procedures performed in healthy donors and patients between January 2008 and December 2011 at the Clinics of Haematology and Transfusiology in St Cyril and Method Hospital in Bratislava (Slovakia) were analysed. Results: With Cobe Spectra apheresis machine it was possible to process larger blood volumes per procedure with higher CD34+ cell collection effi ciency (p = 0.0229) and lower RBC contamination of the harvest than with Amicus (p = 0.0116). On the other hand, Amicus helped to limit PLT contamination of the harvest (p < 0.0001), thus minimizing post-procedural decrease in patient´s PLT count. The highest detected advantage of CVC usage was higher fl ow rate of procedure, thus processing larger blood volumes per unit of time. Interesting fi nding was the tendency to lower harvest PLT contamination (p = 0.054). When LVL was performed, signifi cantly higher HSCs yields were collected, even in "poor mobilizers" when the pre-run parameters were low. Conclusion: Management of PBSC collection requires a particular approach in each subject. Institutionally and individually optimized collection may help to improve the transplantation outcome and decrease the fi nancial costs (Tab. 8, Ref. 15). Text in PDF www.elis.sk.

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Who should be really considered as a poor mobilizer in the plerixafor era?

Cited by 11 publications

References 36 publications

Plerixafor (Mozobil): A Stem Cell-Mobilizing Agent for Transplantation in Lymphoma Patients Predicted to Be Poor Mobilizers - A Pilot Study

Plerixafor (Mozobil): A Stem Cell-Mobilizing Agent for Transplantation in Lymphoma Patients Predicted to Be Poor Mobilizers - A Pilot Study

Hematopoietic stem and progenitor cell harvesting: technical advances and clinical utility

Collection of peripheral hematopoietic stem/progenitor cells

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