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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

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Affiliated Author(s)
도영록
Alternative Author(s)
Do, Young Rok
Journal Title
Annals of Hematology
ISSN
0939-5555
Issued Date
2016
Keyword
PlerixaforGranulocyte colony-stimulating factorMalignant lymphomaMultiplemyelomaMobilizationPrognostic factor
Abstract
Plerixafor in combination with granulocyte colonystimulating
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 withMMachieved 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 orMMwho 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.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Jin Seok Kim et al. (2016). 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. Annals of Hematology, 95(4), 603–611. doi: 10.1007/s00277-016-2589-y
Type
Article
ISSN
0939-5555
DOI
10.1007/s00277-016-2589-y
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33264
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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