title: Mobilization and transplantation patterns of autologous hematopoietic stem cells in multiple myeloma and non-Hodgkin lymphoma.
abstract: BACKGROUND
  The mobilization of hematopoietic stem cells can be a limiting factor for transplantation, yet little is known about how the availability of novel mobilizing agents has affected the practices of oncologists and transplant specialists.
  
  
  METHODS
  US-based oncologists (n = 48) and transplant specialists (n = 46) were separately surveyed with a partial overlap of assessed information.
  
  
  RESULTS
  More transplant specialists than oncologists believed that the time between referral and first consultation is adequate (89.1% vs 54.2%; P < .001). The presence of comorbidities was the most common reason for patients not being referred for transplantation. Among oncologists, 31.3% avoided cyclophosphamide and 16.7% avoided lenalidomide to prevent mobilization impairment in patients with multiple myeloma (MM). Chemotherapy mobilization for MM was used by 23.9% of transplant specialists due to higher CD34+ yields and by 21.7% due to its anti-MM effect. In non-Hodgkin lymphoma (NHL), 26.1% of transplant specialists used chemotherapy mobilization due to higher CD34+ yields, and 26.1% collected hematopoietic stem cells on the rebound prior to chemotherapy. With regard to plerixafor use in MM, 36.9% of transplant specialists reported that they did not use it, and 28.3% said they reserved it for second mobilization. In NHL, 4.3% of transplant specialists reported not using plerixafor, and 39.1% reserved it for second mobilization.
  
  
  CONCLUSIONS
  Educational needs were identified to promote adequate referral for transplantation as well as successful and cost-effective methods for the mobilization of hematopoietic stem cells.
authors.affiliation: Department of Medicine and UAB-CCC, Bone Marrow Transplantation and Cell Therapy Program, University of Alabama at Birmingham, 35294, USA. ljcosta@uabmc.edu.
authors.forename: Luciano J
authors.initials: LJ
authors.lastname: Costa
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Stowell
authors.forename: Shari J
authors.initials: SJ
authors.lastname: Dermer
mesh_terms: D001596:Benzylamines; D000080027:Cyclams; D003520:Cyclophosphamide / Q000627:therapeutic use; D003625:Data Collection; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000276:immunology; D006571:Heterocyclic Compounds / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000077269:Lenalidomide; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D009101:Multiple Myeloma / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D013792:Thalidomide; D003520:Cyclophosphamide; D000077269:Lenalidomide; C088327:plerixafor