Impact of mobilization and remobilization strategies on achieving sufficient stem cell yields for autologous transplantation.

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Iskra PusicJohn F DiPersio

Abstract

The purpose of this article was to examine historic institutional autologous stem cell mobilization practices and evaluate factors influencing mobilization failure and kinetics. In this retrospective study we analyzed clinical records of 1834 patients who underwent stem cell mobilization for autologous transplantation from November 1995 to October 2006 at the Washington University in St. Louis. Successful mobilization was defined as collection of > or =2 x 10(6) CD34(+) cells/kg. From 1834 consecutive patients, 1040 met our inclusion criteria (502 non-Hodgkin's lymphoma [NHL], 137 Hodgkin's lymphoma, and 401 multiple myeloma [MM]). A total of 976 patients received granulocyte colony-stimulating factor (G-CSF) and 64 received G-CSF plus chemotherapy (G/C) for the initial mobilization. Although the median CD34(+) cell yield was higher in G/C group than in G-CSF alone group, the failure rates were similar: 18.8% and 18.6%, respectively. Overall, 53% of patients collected > or =2 x 10(6) CD34(+) cells/kg during the first apheresis with either mobilization regimen. Regardless of mobilization regimen used, MM patients had the highest total CD34(+) cell yield and required less aphereses to collect > or =2 x 10(6) CD34(+) cells/kg. Mob...Continue Reading

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Citations

Jul 3, 2013·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Koji KawamuraYoshinobu Kanda
Jan 14, 2009·Bone Marrow Transplantation·W BensingerJ M McCarty
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Jan 31, 2009·Nature Reviews. Drug Discovery·John F DiPersioPeter Kirkpatrick
Dec 30, 2011·The New England Journal of Medicine·John F DiPersio
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