title: Factors affecting successful mobilization with plerixafor: an Italian prospective survey in 215 patients with multiple myeloma and lymphoma.
abstract: BACKGROUND
  Although the efficacy of plerixafor in peripheral blood stem cell (PBSC) mobilization has been explored in several studies, factors associated with successful plerixafor mobilization after administration of granulocyte-colony-stimulating factor (G-CSF), with or without chemotherapy, have not been investigated. We analyzed data on PBSC mobilization from a large Italian database of lymphoma and myeloma plerixafor-treated patients.
  
  
  METHODS
  Two endpoints were established to define successful mobilization: patients with at least 2 × 10(6) CD34+ cells/kg collected by three leukapheresis procedures and patients achieving a peak count of at least 20 × 10(6) CD34+ cells/L during mobilization.
  
  
  RESULTS
  Plerixafor achieved successful mobilization in both predicted (n = 64) and proven poor mobilizers (PMs; n = 143), classified according to the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) criteria. Successful mobilization was independent of type of mobilization (steady state or chemotherapy); age; sex; disease; number or type of chemotherapy regimens preceding plerixafor; radiation therapy; prior treatment with melphalan, carmustine, lenalidomide, and radioimmune conjugates; and laboratory variables. Multivariate analysis identified previous fludarabine treatment and premobilization platelet count as predictors of successful mobilization.
  
  
  CONCLUSIONS
  This large, prospective, nationwide study confirmed plerixafor efficacy for mobilizing PBSCs when added to G-CSF with or without chemotherapy. Plerixafor can overcome negative effects of most predictors of poor mobilization to achieve satisfactory harvest both in predicted and proven PM.
authors.affiliation: Section of Hematology and BMT Unit, Cremona Hospital, Cremona, Italy; Department of Hematology and Oncological Sciences, Institute of Hematology "L. & A. Seràgnoli", University of Bologna, Bologna, Italy; Section of Hematology, University Hospital of Ancona, "Ospedali Riuniti", Ancona, Italy; Hemato-Oncology Unit, Istituto Europeo Oncologico, Milan, Italy; Section of Hematology, Reggio Calabria Hospital, Reggio Calabria, Italy; Section of Hematology, University Hospital of Bari, Bari, Italy; Section of Hematology, Tricase Hospital, Tricase, Italy; Section the of Hematology, Rimini Hospital, Rimini, Italy; Section of Hematology, University Hospital Ferrarotto, Policlinico Vittorio Emanuele, Catania, Italy; Section of Hematology, Humanitas Hospital; BMT Unit, S. Raffaele Hospital, Milan, Italy; Section of Hematology, Hospital Casa Sollievo Sofferenza, S. Giovanni Rotondo, Italy; Section of Hematology, Bergamo Hospital, Bergamo, Italy; Section of Hematology and BMT Unit, University Hospital "Careggi", Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lanza
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lemoli
authors.forename: Attilio
authors.initials: A
authors.lastname: Olivieri
authors.forename: Daniele
authors.initials: D
authors.lastname: Laszlo
authors.forename: Massimo
authors.initials: M
authors.lastname: Martino
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pavone
authors.forename: Manuela
authors.initials: M
authors.lastname: Imola
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pasini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Milone
authors.forename: Ilaria
authors.initials: I
authors.lastname: Scortechini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Todisco
authors.forename: Elena
authors.initials: E
authors.lastname: Guggiari
authors.forename: Nicola
authors.initials: N
authors.lastname: Cascavilla
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001596:Benzylamines; D001781:Blood Component Removal / Q000379:methods; D059248:Chemoradiotherapy; D000080027:Cyclams; D003625:Data Collection; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans; D007558:Italy; D007937:Leukapheresis / Q000379:methods; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D010976:Platelet Count; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019718:Receptors, CXCR4 / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D019718:Receptors, CXCR4; C088327:plerixafor