CD34+ cell subclasses and lymphocyte subsets in blood grafts collected after various mobilization methods in myeloma patients.
BACKGROUND
Cyclophosphamide (CY) combined with granulocyte-colony-stimulating factor (G-CSF) is commonly used to mobilize stem cells in multiple myeloma (MM). Plerixafor may also be used with G-CSF in patients who mobilize poorly or it may be added to chemomobilization to boost mobilization. Limited data are available on graft content collected after various mobilization methods.


METHODS
Blood grafts collected from 21 MM patients were retrospectively analyzed. We analyzed CD34+ subclasses and lymphocyte subsets from cryopreserved grafts collected on the next morning after plerixafor injection in nine MM patients mobilized with G-CSF with (n = 5) or without preceding CY (n = 4). As controls we had the first collections from 12 MM patients mobilized with low-dose CY with G-CSF.


RESULTS
The proportion of the most primitive stem cells (CD34+CD133+CD38-) from all CD34+ cells in the graft was higher in the plerixafor-treated patients but there was no significant difference in the total number of these cells. The numbers of CD19+ B lymphocytes and natural killer cells were higher in patients collected after G-CSF plus plerixafor when compared to the patients mobilized with CY plus G-CSF. Early engraftment after high-dose melphalan was comparable between the groups.


CONCLUSIONS
Plerixafor appears to have effects on blood stem cell graft composition in myeloma patients. A higher number of grafts should be evaluated in regard to cellular content and longer follow-up of the patients is needed to evaluate the potential clinical impact of graft content.
Department of Medicine, Kuopio University Hospital, Kuopio, Finland. ville.varmavuo@kuh.fi
Ville
V
Varmavuo
Pentti
P
Mäntymaa
Raija
R
Silvennoinen
Tapio
T
Nousiainen
Taru
T
Kuittinen
Esa
E
Jantunen
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000097:blood*; D001596:Benzylamines; D015415:Biomarkers / Q000097:blood; D000080027:Cyclams; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D005434:Flow Cytometry; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology; D006401:Hematologic Agents / Q000008:administration & dosage / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000378:metabolism; D006571:Heterocyclic Compounds / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007937:Leukapheresis; D016131:Lymphocyte Subsets / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D018952:Antigens, CD34; D001596:Benzylamines; D015415:Biomarkers; D000080027:Cyclams; D006401:Hematologic Agents; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; C088327:plerixafor