title: Plerixafor in patients with lymphoma and multiple myeloma: effectiveness in cases with very low circulating CD34+ cell levels and preemptive intervention vs remobilization.
abstract: This retrospective study presents data from 105 consecutive multiple myeloma and lymphoma patients who had PB CD34+ cell counts <10/μL on day 4 of steady-state G-CSF mobilization for autologous hematopoietic cell transplantation. Our results confirm the capacity of plerixafor to improve mobilization outcomes in this clinical setting. In addition, they show that the effectiveness of plerixafor, compared with G-CSF only, translates to patients with very low (<3.5/μL) circulating CD34+ cell counts: overnight CD34+ cell count expansion (5.3- vs 1.7-fold), overall CD34+ cell yield (2.29 vs 0.15 × 10(6) CD34+ cells per kg) and patients yielding ⩾2 × 10(6) CD34+ cells per kg (63% vs 3%). Furthermore, our data also show that preemptive plerixafor is significantly more effective and more efficient than in remobilization: CD34+ cell yield in the first apheresis (3.28 vs 2.0 × 10(6) CD34+ cells per kg) and overall (3.73 vs 2.44 × 10(6) CD34+ cells per kg), patients yielding ⩾2 × 10(6) CD34+ cells per kg in the first apheresis (85% vs 44%) and overall (92% vs 64%), all this requiring less days and doses of plerixafor treatment (1.08 vs 1.48). These data would advocate using plerixafor as an early preemptive intervention based on day 4 circulating CD34+ counts, including very high-risk patients with very low circulating levels.
authors.affiliation: Department of Haematology, Institut Català d'Oncología (ICO) - Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Sánchez-Ortega
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Querol
authors.affiliation: Department of Haematology, Institut Català d'Oncología (ICO) - Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Encuentra
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Ortega
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Serra
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Sanchez-Villegas
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: J R
authors.initials: JR
authors.lastname: Grifols
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: M M
authors.initials: MM
authors.lastname: Pujol-Balaguer
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Pujol-Bosch
authors.affiliation: Hospital Mutua de Terrassa, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Martí
authors.affiliation: Hospital Arnau de Vilanova, Barcelona, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Garcia-Cerecedo
authors.affiliation: Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Barba
authors.affiliation: Institut Català d'Oncologia - Badalona, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Sancho
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Esquirol
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.affiliation: Department of Haematology, Institut Català d'Oncología (ICO) - Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: R F
authors.initials: RF
authors.lastname: Duarte
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018952:Antigens, CD34 / Q000097:blood*; D064592:Autografts; D001596:Benzylamines; D000080027:Cyclams; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D019650:Hematopoietic Stem Cell Mobilization; D006571:Heterocyclic Compounds / Q000008:administration & dosage*; D006801:Humans; D007958:Leukocyte Count; D008223:Lymphoma / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents; D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor