Haematopoietic stem cell mobilization with plerixafor and G-CSF in patients with multiple myeloma transplanted with autologous stem cells

Eur J Haematol. 2011 Jun;86(6):488-95. doi: 10.1111/j.1600-0609.2011.01605.x. Epub 2011 Apr 1.

Abstract

A proportion of patients with multiple myeloma (MM) who have already undergone autologous stem cell transplantation (autoSCT) might benefit from a further transplantation. For this, they might need to undergo another round of stem cell mobilization. We analyzed retrospectively the outcomes of stem cell mobilization with plerixafor and granulocyte colony-stimulating factor (G-CSF) in a group of 30 patients who had undergone autoSCT previously, and in 46 other patients. The previously transplanted patients were significantly different from the remaining patients with respect to the intensity and number of previous therapies. We observed that the median peripheral blood concentration of CD34+ cells after the first administration of plerixafor was lower in previously transplanted (19 cells/μL) than in other patients (30 cells/μL, P < 0.05). Despite a comparable number of apheresis sessions being performed, the median total yield of CD34+ cells was significantly lower in the previously transplanted than in the remaining patients (2.8 × 10(6) cells/kg vs. 4.2 × 10(6) cells/kg, P < 0.05). However, successful collection of at least 2.0 × 10(6) CD34+ cells/kg was achieved finally in a similar proportion of previously transplanted and other patients (70% vs. 82.6%). Our data suggest that stem cell mobilization with plerixafor and G-CSF might overcome the negative effect of prognostic factors for poor stem cell mobilization in patients with MM who have undergone autoSCT previously.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Benzylamines
  • Cyclams
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cell Transplantation*
  • Heterocyclic Compounds / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / blood
  • Multiple Myeloma / therapy*
  • Receptors, CXCR4 / antagonists & inhibitors
  • Recombinant Proteins
  • Recurrence
  • Retrospective Studies
  • Transplantation, Autologous

Substances

  • Benzylamines
  • Cyclams
  • Heterocyclic Compounds
  • Receptors, CXCR4
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • plerixafor