Prognostic factors for re-mobilization using plerixafor and granulocyte colony-stimulating factor (G-CSF) in patients with malignant lymphoma or multiple myeloma previously failing mobilization with G-CSF with or without chemotherapy: the Korean multicenter retrospective study

Jin Seok Kim, Dok Hyun Yoon, Seonyang Park, Sung Soo Yoon, Seok Goo Cho, Chang Ki Min, Je Jung Lee, Deok Hwan Yang, Jae Yong Kwak, Hyeon Seok Eom, Won Seog Kim, Hawk Kim, Young Rok Do, Joon Ho Moon, Jihye Lee, Cheolwon Suh

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Abstract

Plerixafor in combination with granulocyte colony-stimulating factor (G-CSF) has been shown to improve the rates of successful peripheral blood stem cell (PBSC) mobilization in patients with malignant lymphoma or multiple myeloma (MM) who experienced prior failure of PBSC mobilization. We evaluated the mobilization results of re-mobilization using plerixafor and G-CSF in insufficiently mobilizing patients. Forty-four patients with lymphoma (n = 29) or MM (n = 15) were included in the study. The median age was 50 (range, 24–64) years. Previous mobilization regimens were chemotherapy with G-CSF (n = 28), including cyclophosphamide with G-CSF (n = 15), and G-CSF only (n = 16). All patients with lymphoma achieved at least partial response (PR) before the mobilization, including 13 complete responses (CRs). Eleven patients with MM achieved at least PR and four patients with MM were in stable disease before mobilization. The median number of apheresis was 3 (range, 1–6). The median yield of PBSC collections was 3.41 (0.13–38.11) × 106 CD34+ cells/kg. Thirty-four (77.3 %) patients had successful collections defined as at least 2 × 106 CD34+ cells/kg. The rate of successful collections was not different between the two underlying diseases (79.3 % in lymphoma and 73.3 % in MM). Of the entire cohort, 38 (86.4 %) of patients went on to receive an autologous transplant. Previous long-term use of high-risk drugs (>4 cycles use of alkylating agents, platinum-containing agents, or thalidomide) (HR 10.8, 95 % CI 1.1–110.0, P = 0.043) and low platelet count (<100 × 109/L) 1 day before the first apheresis (HR 27.9, 95 % CI 2.9–273.7, P = 0.004) were independent prognostic factors for predicting failure of PBSC re-mobilization using plerixafor and G-CSF. In conclusion, re-mobilization using plerixafor and G-CSF showed a success rate of 77.3 % in patients with lymphoma or MM who experienced prior failure of PBSC mobilization, and the majority of them underwent autologous transplant. Therefore, plerixafor-based re-mobilization was an effective method in poor mobilizers.

Original languageEnglish
Pages (from-to)603-611
Number of pages9
JournalAnnals of Hematology
Volume95
Issue number4
DOIs
Publication statusPublished - 2016 Mar 1

All Science Journal Classification (ASJC) codes

  • Hematology

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