scholarly journals Prediction of Poor Mobilization of Autologous CD34+ Cells with Growth Factor in Multiple Myeloma Patients: Implications for Risk-Stratification

2014 ◽  
Vol 20 (2) ◽  
pp. 222-228 ◽  
Author(s):  
Luciano J. Costa ◽  
Elizabeth J. Nista ◽  
Francis K. Buadi ◽  
Martha Q. Lacy ◽  
Angela Dispenzieri ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Growth Factor ◽  
Risk Stratification ◽  
Cd34 Cells

scholarly journals A Comparison of Efficacy Following Two Different Doses of Granulocyte Colony Stimulating Factor (G-CSF) Alone for Mobilization of Peripheral Blood Stem Cells in 221 Multiple Myeloma Patients

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5732-5732
Author(s):  
Soufi Osmani ◽  
Mohamed Brahimi ◽  
Souad Talhi ◽  
Kamila Amani ◽  
Hafida Ouldjeriouat ◽  
...  
Keyword(s):  
Stem Cells ◽  
Multiple Myeloma ◽  
Stem Cell ◽  
Growth Factors ◽  
Growth Factor ◽  
Conflicts Of Interest ◽  
Peripheral Blood Stem Cells ◽  
Hematopoietic Stem ◽  
Cd34 Cells ◽  
Significant Difference

Abstract Introduction: Intensive chemotherapy followed by autologous stem cell transplantation (ASCT) is currently the treatment of choice in multiple myeloma (MM). Mobilization of hematopoietic stem cell blood (HSCs) can be achieved either by the combination of chemotherapy plus growth factors or by growth factors alone. However, there is no consensus concerning the dose of growth factor alone that should be administered, with ranges varying from 5 microgr to 16 microgr/kg body weight. In this context, we report our experience in mobilization of HSCs using growth factor alone at the dose between 15 microgr /kg and 10 microgr /kg in MM. Patients and methods: A total of 340 ASCT were performed in our center, from May 2009 until June the 31st 2016. These concerned 221 patients with MM. Patients were hospitalized at day -5 on which mobilization started with G-CSF alone (filgrastim) at the dose of 15 microgr /kg/daily subcutaneously for 5 days from May 2009 to October 2012 and at the dose of 10 microgr /kg from November 2012 to June 2016. The white blood cell count was assessed daily. Apheresis was performed at day -2 and day -1 using a Spectra Optia CMN device, and the CD34+ count was assessed by flow cytometry. A single leukapheresis was performed if the number of CD34+ cells was above 2.106/kg. Failure of mobilization was defined as a level of CD34+ less than 2.106/kg, after two leukapheresis. In our study patients were divided into two groups: Group1 (G-CSF=15 microgr /kg) and Group 2 (G-CSF=10 microgr /kg) and the number of CD34+ were divided into three groups: optimal (³5.0 x 106 CD34+ cells/kg), suboptimal (2.0Ð5.0 x 106 CD34+ cells/kg) and poor (<2.0 x 106 CD34+ cells/kg) mobilization. Intensification was done using melphalan 200 mg/m2 on day -1. Results: Patient's characteristics are shown in Table 1. No significant difference was observed between the 2 groups. In this study, we found no significant difference in terms of optimal (p= 0.73), sub-optimal (p= 0.19) or poor (p= 0.11) harvest of stem cells between the 2 groups (table 2). Among the poor mobilizators with G-CSF, only 4 of them had a level of CD34+ harvest less than 0.5 x 106/kg. These patients did not receive an ASCT. 1,3% (4) of all apheresis failed to achieve acceptable harvest level. Conclusion: Our study showed that the mobilization regimen with G-CSF alone at the doses of 10 microgr/kg have the same efficacy as the doses of 15 microgr/kg and is interesting alternative to chemotherapy and G-CSF in patients with MM because it can be administered as an outpatient and is not associated with the risk of febrile neutropenia. Disclosures No relevant conflicts of interest to declare.

Peripheral Blood Hematopoietic Progenitor Cell (HPC) Counts At Autologous Stem Cell Collection (ASCC) Are Associated with Prognosis in Multiple Myeloma

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4412-4412
Author(s):  
Yoon Ji Choi ◽  
Dok Hyun Yoon ◽  
Jungmin Jo ◽  
Kyoungmin Lee ◽  
Eun Hee Kang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Growth Factor ◽  
Prognostic Factor ◽  
Induction Chemotherapy ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor ◽  
Cd34 Cells ◽  
Stem Cell Collection

Abstract Abstract 4412 Background High-dose chemotherapy followed by autologous stem cell transplantation (HDC-ASCT) has been adopted as the first-line treatment for young and/or fit patients with multiple myeloma, providing higher remission rates. However, only few factors have been identified affecting the outcome in such patients. One previous retrospective study suggest that high levels of mobilized peripheral CD34+ cells are associated with favorable outcome in myeloma patients undergoing HDC-ASCT. However, prognostic significance of hematopoietic progenitor cell (HPC) count (Suh C, Transfusion 2004), an estimate of immature cells used for timing stem cell harvest instead of CD34+ cell count, has not been investigated yet. Methods We measured peripheral HPC counts at the day 1 of autologous stem cell collection (ASCC) by Sysmex SE9000 in 112 myeloma patients at the Asan Medical Center between May 2000 and May 2012. Patients were divided into two groups (super vs normal mobilizers) with a cutoff of 50 HPC count per μL. Results Among 112 patients, 34 had more than 50 HPCs per μL (super mobilizers) and 76 had less than 50 HPCs per μL (normal mobilizers). The two groups showed no differences with regards to age, sex, subtype, light chain, ISS stage at diagnosis, performance, cytogenetics, BM plasma cells, the regimen used for induction chemotherapy and response to induction chemotherapy. However, more patients of super mobilisers received tandem ASCT comparing to normal mobilizers (35.3% vs 14.3%; p=0.052). In addition, all super mobilizers received chemotherapy combined with growth factor as mobilization, 15.6% of normal mobilizers received growth factor only (p=0.017). The mean number of HPCs in the super mobilizer group was 167.3 ± 25.7 per μL, and 16.5 ± 1.5 per μL in the normal mobilizer group (p<0.001). The total number of CD34+ cells collected at apheresis was higher in the super mobilizer group (23.9 ± 2.5 × 106 per kg vs 17.5 ± 1.34×106 per kg; p=0.029) and the super mobilizer group tended to receive more CD34+ cells at transplantation (13.6 ± 1.5 × 106 per kg vs. 10.5 ± 0.9 × 106 per kg; p=0.063). However, time to engraftment was not different between two groups. After a median follow-up of 81.6 months, progression free survival (PFS) did not differ between the arms (18.87 months vs 19.47 months; p=0.937). However, the super mobilizer group showed a relatively longer overall survival (OS), with a median OS of 77.9 months compared with 48.9 months in the normal mobilizer group (p=0.099). In multivariate analysis, good performance (p=0.046) and response to induction treatment (p=0.009) were associated with prolonged OS. And the level of peripheral HPCs also revealed to be an independent prognostic factor for OS (HR=0.518, 95% CI: 0.285–0.940; p=0.031). Conclusion Our results suggest that high levels of peripheral HPCs at the day 1 of apheresis might be an independent prognostic factor for OS in myeloma patients undergoing HDC-ASCT, which warrants further investigation Disclosures: No relevant conflicts of interest to declare.

SOME ASPECTS OF AUTOTRANSPLANT COLLECTION IN PATIENTS WITH MULTIPLE MYELOMA

2019 ◽  
Vol 65 (4) ◽  
pp. 504-509
Author(s):  
Ivan Kostroma ◽  
Anastasiya Zhernyakova ◽  
Sergey Gritsaev
Keyword(s):  
Multiple Myeloma ◽  
Effective Regimen ◽  
Cd34 Cells

The review discusseds some problems of autotransplant harvesting in patients with multiple myeloma (MM). The main mobilization regimens and their modifications ensured receipt of suboptimal of CD34+ cells number are described. The expansion of mobilization regimen’s spectrum and finding of predictors which associated with autotransplant harvesting failures is the possibility to choose more effective regimen for individual MM patient.

Rapid Mobilization of CD34+ Cells Following Administration of the CXCR4 Antagonist AMD3100 to Patients With Multiple Myeloma and Non-Hodgkin's Lymphoma

2004 ◽  
Vol 22 (6) ◽  
pp. 1095-1102 ◽  
Author(s):  
Steven M. Devine ◽  
Neal Flomenberg ◽  
David H. Vesole ◽  
Jane Liesveld ◽  
Daniel Weisdorf ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Clinical Effects ◽  
Cxcr4 Antagonist ◽  
Cell Counts ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Cd34 Cells ◽  
The Absolute

PurposeInteractions between the chemokine receptor CXCR4 and its ligand stromal derived factor-1 regulate hematopoietic stem-cell trafficking. AMD3100 is a CXCR4 antagonist that induces rapid mobilization of CD34+ cells in healthy volunteers. We performed a phase I study assessing the safety and clinical effects of AMD3100 in patients with multiple myeloma (MM) and non-Hodgkin's lymphoma (NHL).Patients and MethodsThirteen patients (MM, n = 7; NHL, n = 6) received AMD3100 at a dose of either 160 μg/kg (n = 6) or 240 μg/kg (n = 7). WBC and peripheral blood (PB) CD34+ cell counts were analyzed at 4 and 6 hours following injection.ResultsAMD3100 caused a rapid and statistically significant increase in the total WBC and PB CD34+ counts at both 4 and 6 hours following a single injection. The absolute CD34+ cell count increased from a baseline of 2.6 ± 0.7/μL (mean ± SE) to 15.6 ± 3.9/μL and 16.2 ± 4.3/μL at 4 hours (P = .002) and 6 hours after injection (P = .003), respectively. The absolute CD34+ cell counts observed at 4 and 6 hours following AMD3100 were higher in the 240 μg/kg group (19.3 ± 6.9/μL and 20.4 ± 7.6/μL, respectively) compared with the 160 μg/kg group (11.3 ± 2.7/μL and 11.3 ± 2.5/μL, respectively). The drug was well tolerated and only grade 1 toxicities were encountered.ConclusionAMD3100 appears to be a safe and effective agent for the rapid mobilization of CD34+ cells in patients who have received prior chemotherapy. Further studies in combination with granulocyte colony-stimuating factor in patients with lymphoid malignancies are warranted.

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