Long-term follow up of patients proceeding to transplant using plerixafor mobilized stem cells and incidence of secondary myelodysplastic syndrome/AML

Bone Marrow Transplant. 2013 Aug;48(8):1112-6. doi: 10.1038/bmt.2013.10. Epub 2013 Mar 11.

Abstract

We report the long-term follow up of 49 patients (pts) enrolled on plerixafor compassionate use protocol. Thirty-seven pts (76%) had failed one previous mobilization attempt, while 12 (24%) had failed two or more previous attempts. Using the combination of plerixafor and granulocyte colony-stimulating factor, we collected2.5 × 10(6) CD34+cells/kg in 33 pts (67%). Forty-three of the 49 pts proceeded to an auto-SCT (ASCT). The median days to WBC and platelet engraftment were 11 (range, 9-13 days) and 16 (range, 11-77 days) days post ASCT, respectively. The median WBC count, Hb and platelet counts 1 year after ASCT were 4.7 × 10(9)/L, 12.2 g/dL and 109 × 10(9)/L, respectively. With median follow up of 42 months (range <1-54 months), 21 pts had evidence of disease progression. Five pts developed myelodysplastic syndrome (MDS)/AML at median of 29 months post ASCT. The cumulative incidence of MDS/AML at 42 months was 17% (95% confidence interval, 6 to 32%). Development of secondary MDS/AML in pts proceeding to ASCT after plerixafor mobilization needs to be studied further in a larger cohort.

Trial registration: ClinicalTrials.gov NCT00291811.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Benzylamines
  • Compassionate Use Trials
  • Cyclams
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Mobilization / adverse effects
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods
  • Hematopoietic Stem Cells / cytology
  • Hematopoietic Stem Cells / drug effects
  • Heterocyclic Compounds / administration & dosage*
  • Humans
  • Incidence
  • Leukemia, Myeloid, Acute / etiology*
  • Leukemia, Myeloid, Acute / immunology
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / etiology*
  • Myelodysplastic Syndromes / immunology
  • Neoplasms, Second Primary / etiology*
  • Neoplasms, Second Primary / immunology
  • Survival Analysis
  • Treatment Outcome
  • Young Adult

Substances

  • Benzylamines
  • Cyclams
  • Heterocyclic Compounds
  • plerixafor

Associated data

  • ClinicalTrials.gov/NCT00291811