title: Proposed definition of 'poor mobilizer' in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo ItalianoTrapianto di Midollo Osseo.
abstract: Many lymphoma and myeloma patients fail to undergo ASCT owing to poor mobilization. Identification of poor mobilizers (PMs) would provide a tool for early intervention with new mobilization agents. The Gruppo italianoTrapianto di Midollo Osseo working group proposed a definition of PMs applicable to clinical trials and clinical practice. The analytic hierarchy process, a method for group decision making, was used in setting prioritized criteria. Lymphoma or myeloma patients were defined as 'proven PM' when: (1) after adequate mobilization (G-CSF 10 μg/kg if used alone or ≥5 μg/kg after chemotherapy) circulating CD34(+) cell peak is <20/μL up to 6 days after mobilization with G-CSF or up to 20 days after chemotherapy and G-CSF or (2) they yielded <2.0 × 10(6) CD34(+) cells per kg in ≤3 apheresis. Patients were defined as predicted PMs if: (1) they failed a previous collection attempt (not otherwise specified); (2) they previously received extensive radiotherapy or full courses of therapy affecting SC mobilization; and (3) they met two of the following criteria: advanced disease (≥2 lines of chemotherapy), refractory disease, extensive BM involvement or cellularity <30% at the time of mobilization; age ≥65 years. This definition of proven and predicted PMs should be validated in clinical trials and common clinical practice.
authors.affiliation: Unità Operativa di Ematologia e Trapianto di Cellule Staminali, Ospedale San Carlo, Potenza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Olivieri
authors.forename: M
authors.initials: M
authors.lastname: Marchetti
authors.forename: R
authors.initials: R
authors.lastname: Lemoli
authors.forename: C
authors.initials: C
authors.lastname: Tarella
authors.forename: A
authors.initials: A
authors.lastname: Iacone
authors.forename: F
authors.initials: F
authors.lastname: Lanza
authors.forename: A
authors.initials: A
authors.lastname: Rambaldi
authors.forename: A
authors.initials: A
authors.lastname: Bosi
mesh_terms: D000368:Aged; D018952:Antigens, CD34 / Q000096:biosynthesis; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001781:Blood Component Removal; D002986:Clinical Trials as Topic; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007558:Italy; D008223:Lymphoma / Q000628:therapy*; D008495:Medical Oncology / Q000379:methods; D009101:Multiple Myeloma / Q000628:therapy*; D011878:Radiotherapy / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D018952:Antigens, CD34; D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor