title: Peripheral blood CD34+ percentage at hematological recovery after chemotherapy is a good early predictor of harvest: a single-center experience.
abstract: Several algorithms for early prediction of poor-mobilizing patients after chemotherapy and granulocyte colony-stimulating factor administration have been proposed. They generally define peripheral blood cut-off levels of CD34+ cells at a fixed day after starting chemotherapy, mostly with cyclophosphamide. To define an algorithm for early addition of plerixafor regardless of the chemotherapy regimen used, we retrospectively analyzed 280 chemomobilization attempts in 236 patients treated at our institution between 2002 and 2012. In multivariate analysis, CD34+ absolute count and CD34+ percentage upon total leukocyte count at day 1 (defined as the first day in which leukocytes reached a value > 1 × 10(9)/L) were the only factors able to predict a total harvest ≥ 2 × 10(6) CD34+/kg. In patients with day 1 CD34+ lower than 20/μL, the CD34+ percentage was a more reliable predictor of stem cell harvest in the following days than CD34+ absolute count. Upon definition of the best CD34+ cut-off value for identification of poor-mobilizing patients, an algorithm was set up to guide plerixafor administration. It was prospectively validated in 20 patients in 2013 with encouraging results in terms of low incidences of both mobilization failure and plerixafor use. Large prospective trials that define the most cost-effective strategy for just-in-time rescue plerixafor are warranted.
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy. Electronic address: sorasio.r@ospedale.cuneo.it.
authors: Roberto
authors: R
authors: Sorasio
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Margherita
authors: M
authors: Bonferroni
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Mariella
authors: M
authors: Grasso
authors: Laboratory Department, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Giuliana
authors: G
authors: Strola
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Davide
authors: D
authors: Rapezzi
authors: Immunohematology and Transfusion Medicine, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Dario
authors: D
authors: Marenchino
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Cristina
authors: C
authors: Di Marco
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Claudia
authors: C
authors: Castellino
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Daniele
authors: D
authors: Mattei
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Nicola
authors: N
authors: Mordini
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Francesca
authors: F
authors: Fiore
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Ivana
authors: I
authors: Celeghini
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Anna
authors: A
authors: Borra
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy.
authors: Annalisa
authors: A
authors: Ghiglia
authors: Division of Haematology, Santa Croce e Carle Hospital, Cuneo, Italy; Onco-haematology Department, A. Lacassagne Cancer Center, University of Nice, Nice, France.
authors: Andrea
authors: A
authors: Gallamini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols; D001596:Benzylamines; D015415:Biomarkers / Q000378:metabolism; D000080027:Cyclams; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006689:Hodgkin Disease / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007958:Leukocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D015415:Biomarkers; D000080027:Cyclams; D006571:Heterocyclic Compounds; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; C088327:plerixafor
keywords: Mobilization failure; Plerixafor