1. Hematopoietic recovery kinetics predicts for poor CD34+ cell mobilization after cyclophosphamide chemotherapy in multiple myeloma.
- Author
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Ozsan GH, Micallef IN, Dispenzieri A, Kumar S, Lacy MQ, Dingli D, Hayman SR, Buadi FK, Wolf RC, Gastineau DA, Hogan WJ, and Gertz MA
- Subjects
- Aged, Antigens, CD34 analysis, Combined Modality Therapy, Granulocyte Colony-Stimulating Factor therapeutic use, Hematologic Tests, Humans, Kinetics, Middle Aged, Multiple Myeloma drug therapy, Prognosis, Antineoplastic Agents therapeutic use, Cyclophosphamide therapeutic use, Hematopoietic Stem Cell Mobilization, Multiple Myeloma therapy
- Abstract
Autologous stem cell transplantation is an important part of therapy in patients with multiple myeloma. Some patients fail to collect the desired number of stem cells while others require multiple apheresis to reach the desired apheresis target. The aim of this study was to determine the predictive factors and if the hematopoietic kinetics of recovery were predictive for outcome of stem cell mobilization in cyclophosphamide + growth factor (CY-GF) mobilized patients. Three hundred and ninety six consecutive CY-GF mobilization attempts between January 2000 and December 2009 at Mayo Clinic, Rochester, MN were analyzed. Patients were divided into three groups: optimal (>5 × 10(6) CD34/kg), suboptimal (2-5 × 10(6) CD34/kg) and poor (<2 × 10(6) /kg CD34+ cells) mobilization groups. About 86% of patients had optimal stem cell collection, whereas 8% had suboptimal collection and 6% had poor (or failed) collections. Age, Hb, WBC, and platelet levels had an impact on mobilization results. Time to peripheral blood (PB) CD34+cells >10/μL predicted for efficiency of collection and the interval between recovery of WBC>1 post-CY to PB CD34+ cells>10 was shorter in the optimal collection groups. These findings suggest that for patients with a PB CD34+ cell count below 10/μL on Day 13 following CY or 1 day after the WBC>1 × 10(9) /L, addition of plerixafor may be helpful to salvage the mobilization attempt., (Copyright © 2011 Wiley Periodicals, Inc.)
- Published
- 2012
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