TY - JOUR
T1 - 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
T2 - the Korean multicenter retrospective study
AU - Kim, Jin Seok
AU - Yoon, Dok Hyun
AU - Park, Seonyang
AU - Yoon, Sung Soo
AU - Cho, Seok Goo
AU - Min, Chang Ki
AU - Lee, Je Jung
AU - Yang, Deok Hwan
AU - Kwak, Jae Yong
AU - Eom, Hyeon Seok
AU - Kim, Won Seog
AU - Kim, Hawk
AU - Do, Young Rok
AU - Moon, Joon Ho
AU - Lee, Jihye
AU - Suh, Cheolwon
N1 - Funding Information:
This study was supported by Sanofi-Aventis Korea Ltd.
Publisher Copyright:
© 2016, Springer-Verlag Berlin Heidelberg.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - 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.
AB - 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.
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U2 - 10.1007/s00277-016-2589-y
DO - 10.1007/s00277-016-2589-y
M3 - Article
C2 - 26754633
AN - SCOPUS:84959573566
SN - 0939-5555
VL - 95
SP - 603
EP - 611
JO - Annals of Hematology
JF - Annals of Hematology
IS - 4
ER -