title: Incidence and risk factors of poor mobilization in adult autologous peripheral blood stem cell transplantation: a single-centre experience.
abstract: OBJECTIVE
  Collection of sufficient CD34+ cells for autologous peripheral blood stem cell (PBSC) transplantation is frequently failed in patients with lymphoma or multiple myeloma (MM). We investigated the incidence and the predictive factors for poor mobilization.
  
  
  METHODS
  A total of 205 adult patients (101 lymphoma and 104 MM) were retrospectively included for identifying the incidence of mobilization failure and the predictive factors for poor mobilization in conventional G-CSF-based mobilization regimen. Another 17 patients who used plerixafor for mobilization were included.
  
  
  RESULTS
  Overall, 14·1% of patients (21·8% of patients with lymphoma, 6·7% of patients with MM) were poor mobilizers. Univariate analysis and multivariate analysis revealed an interval from G-CSF administration to PBSC collection exceeding 10 days and peripheral blood mononuclear cells count on the first day of collection were predictive factors for poor mobilization in lymphoma, but not in MM. Among plerixafor-treated patient group, 9 of 11 poor mobilizers who received second-cycle plerixafor mobilization were able to collect higher number of CD34+ cells than that of CD34+ cells during the G-CSF-based first mobilization. All patients who had received initial plerixafor mobilization reached 2·0 × 10(6) CD34+ cells/kg during the four leukaphereses.
  
  
  CONCLUSIONS
  In conventional G-CSF-based mobilization, early PBSC collection after G-CSF administration might enhance CD34+ cell yield. A combination of a new mobilizing agent, plerixafor, would be helpful to harvest sufficient number of CD34+ cells for successful transplantation outcome while reducing the effort of collection procedures in poor mobilizers.
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Lee
authors.forename: S K
authors.initials: SK
authors.lastname: Jung
authors.forename: S J
authors.initials: SJ
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Jang
authors.forename: K
authors.initials: K
authors.lastname: Kim
authors.forename: W S
authors.initials: WS
authors.lastname: Kim
authors.forename: C W
authors.initials: CW
authors.lastname: Jung
authors.forename: D W
authors.initials: DW
authors.lastname: Kim
authors.forename: E S
authors.initials: ES
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D001596:Benzylamines; D000080027:Cyclams; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization / Q000706:statistics & numerical data; D006571:Heterocyclic Compounds / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000378:metabolism; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D015999:Multivariate Analysis; D036102:Peripheral Blood Stem Cell Transplantation; D012189:Retrospective Studies; D012307:Risk Factors; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor
keywords: CD34+ cells; autologous peripheral blood stem cell transplantation; plerixafor; poor mobilization; predictive factor