title: Blood graft cellular composition and posttransplant recovery in non-Hodgkin's lymphoma patients mobilized with or without plerixafor: a prospective comparison.
abstract: BACKGROUND
  Autologous stem cell transplantation is commonly used to treat non-Hodgkin's lymphomas (NHLs). Cellular composition of the blood grafts apparently has a role in the posttransplant hematologic and immune recovery. Plerixafor increases the mobilization of CD34+ cells and higher amounts of various lymphocyte subsets have been reported in the grafts. Limited prospective data are available in regard to graft cellular composition, hematologic and immune recovery, and patient outcomes in NHL patients who receive plerixafor added to chemomobilization.
  
  
  METHODS
  Forty-one patients with NHL participated in this prospective study. All patients received chemomobilization and 15 poor mobilizers also received plerixafor. CD34+ cell subsets and lymphocyte subsets of cell grafts, posttransplant hematologic and immune recovery, and outcome were evaluated.
  
  
  RESULTS
  Blood grafts in the plerixafor group contained a significantly higher proportion of CD34+133+CD38- cells and more lymphocytes of all major subsets except B lymphocytes. Neutrophil engraftment was comparable and platelet recovery slightly slower in the plerixafor group. Natural killer cell recovery was significantly faster in patients mobilized with plerixafor. Otherwise hematologic and immune recovery as well as short-time outcome were comparable even though there was a trend for progression-free survival and overall survival benefit in the plerixafor group.
  
  
  CONCLUSIONS
  In poorly mobilizing NHL patients, plerixafor added to chemomobilization is safe and effective. It also modifies the blood graft composition in many ways, some of which have been linked to better outcomes in previous studies. Larger sets of patients and longer follow-up are needed to see whether plerixafor-mobilized grafts are associated with superior outcome of the patients.
authors.affiliation: Department of Medicine, Kuopio University Hospital.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Valtola
authors.affiliation: Department of Medicine, Kuopio University Hospital.
authors.forename: Ville
authors.initials: V
authors.lastname: Varmavuo
authors.affiliation: Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Ropponen
authors.affiliation: Department of Medicine, Central Hospital of Northern Carelia, Joensuu, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Nihtinen
authors.affiliation: Department of Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Partanen
authors.affiliation: Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland.
authors.forename: Kaija
authors.initials: K
authors.lastname: Vasala
authors.affiliation: Department of Medicine, Central Hospital of South Carelia, Lappeenranta, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Lehtonen
authors.affiliation: Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland.|Finnish Medicines Agency.
authors.forename: Karri
authors.initials: K
authors.lastname: Penttilä
authors.affiliation: Department of Medicine, Kuopio University Hospital.
authors.forename: Marja
authors.initials: M
authors.lastname: Pyörälä
authors.affiliation: Department of Medicine, Kuopio University Hospital.
authors.forename: Taru
authors.initials: T
authors.lastname: Kuittinen
authors.affiliation: Department of Medicine, Kuopio University Hospital.
authors.forename: Raija
authors.initials: R
authors.lastname: Silvennoinen
authors.affiliation: Department of Medicine, Kuopio University Hospital.
authors.forename: Tapio
authors.initials: T
authors.lastname: Nousiainen
authors.affiliation: Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland.|Laboratory of Eastern Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Pelkonen
authors.affiliation: Laboratory of Eastern Finland.
authors.forename: Pentti
authors.initials: P
authors.lastname: Mäntymaa
authors.affiliation: Department of Medicine, Kuopio University Hospital.|University of Eastern Finland/Clinical Medicine, Kuopio, Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Jantunen
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D064592:Autografts; D001596:Benzylamines; D000080027:Cyclams; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007962:Leukocytes / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000401:mortality / Q000628:therapy*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D019380:Anti-HIV Agents; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; C088327:plerixafor