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Preemptive plerixafor injection added to pegfilgrastim after chemotherapy in non-Hodgkin lymphoma patients mobilizing poorly
- Source :
- Annals of Hematology. 96:1897-1906
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Filgrastim is usually combined with chemotherapy to mobilize hematopoietic progenitor cells in non-Hodgkin lymphoma (NHL) patients. Limited information is available on the efficacy of a preemptive plerixafor (PLER) injection in poor mobilizers after chemotherapy and pegfilgrastim. In this prospective study, 72 patients with NHL received chemotherapy plus pegfilgrastim, and 25 hard-to-mobilize patients received also PLER. The usefulness and efficacy of our previously developed algorithm for PLER use in pegfilgrastim-containing mobilization regimen were evaluated as well as the graft cellular composition, hematological recovery, and outcome after autologous stem cell transplantation (auto-SCT) according to the PLER use. A median 3.4-fold increase in blood CD34+ cell counts was achieved after the first PLER dose. The minimum collection target was achieved in the first mobilization attempt in 66/72 patients (92%) and 68 patients (94%) proceeded to auto-SCT. An algorithm for PLER use was fulfilled in 76% of the poor mobilizers. Absolute numbers of T-lymphocytes and NK cells were significantly higher in the PLER group, whereas the number of CD34+ cells collected was significantly lower. Early neutrophil engraftment was slower in the PLER group, otherwise hematological recovery was comparable within 12 months from auto-SCT. No difference was observed in survival according to the PLER use. Chemotherapy plus pegfilgrastim combined with preemptive PLER injection is an effective and convenient approach to minimize collection failures in NHL patients intended for auto-SCT. A significant effect of PLER on the graft cellular composition was observed, but no difference in outcome after auto-SCT was detected.
- Subjects :
- Adult
Male
Oncology
Benzylamines
medicine.medical_specialty
Filgrastim
Injections, Subcutaneous
medicine.medical_treatment
030204 cardiovascular system & hematology
Cyclams
Polyethylene Glycols
Young Adult
03 medical and health sciences
0302 clinical medicine
Autologous stem-cell transplantation
Heterocyclic Compounds
hemic and lymphatic diseases
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Granulocyte Colony-Stimulating Factor
medicine
Humans
Prospective Studies
Melphalan
Aged
Podophyllotoxin
Chemotherapy
Neutrophil Engraftment
business.industry
Lymphoma, Non-Hodgkin
Plerixafor
Cytarabine
Hematology
General Medicine
Middle Aged
Carmustine
Hematopoietic Stem Cell Mobilization
Recombinant Proteins
Surgery
Transplantation
Regimen
Drug Therapy, Combination
Female
business
Pegfilgrastim
030215 immunology
medicine.drug
Subjects
Details
- ISSN :
- 14320584 and 09395555
- Volume :
- 96
- Database :
- OpenAIRE
- Journal :
- Annals of Hematology
- Accession number :
- edsair.doi.dedup.....35559416c46f431b0df5ebe38a91383c