title: Engraftment and outcomes following autologous stem cell transplantation in Hodgkin lymphoma patients mobilized with plerixafor.
abstract: Plerixafor has been used to improve peripheral blood stem cell (PBSC) mobilization in multiple myeloma, non-Hodgkin lymphoma, and very recently in Hodgkin lymphoma (HL) patients. Because prior studies have suggested that mobilization with plerixafor affects the composition of mobilized cells, there are concerns that this may in turn adversely impact the immune reconstitution and longer term outcomes of transplanted patients. However, data on the engraftment characteristics and long-term post-transplant outcomes in patients transplanted with plerixafor-mobilized PBSCs are lacking. This retrospective study examined the post-transplant outcomes of 105 consecutive adult HL patients, and compared the post-transplant outcomes of 21 patients who received plerixafor in addition to G-CSF ± chemotherapy because of poor mobilization with those of 84 patients who mobilized well without plerixafor. Despite collecting significantly lower CD34+ cell doses (median of 3.41 vs. 6.05 × 106/kg, p < 0.0001) than control patients and requiring more collection days, plerixafor-mobilized patients showed comparable early engraftment characteristics, except for slightly delayed neutrophil engraftment (median: 11 vs.10 days, p = 0.002) and lower median neutrophil counts (2.1 vs. 2.6 × 109/L, p = 0.04) at one month after transplant. No significant differences were observed in longer term post-transplant outcomes, including cell counts at 3, 6, and 12 months, RBC and platelet transfusion support during the first 120 days, relapse incidence, overall and progression-free survival rates up to two years post transplant. The use of plerixafor not only enabled poorly mobilizing HL patients to collect enough PBSCs to proceed to ASCT, but also to have similar post-transplant outcomes compared to patients who mobilized well with conventional regimens. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine, City of Hope National Medical Center, Duarte, CA, USA.
authors.forename: Shan
authors.initials: S
authors.lastname: Yuan
authors.affiliation: Division of Biostatistics, Department of Information Sciences, City of Hope National Medical Center, Duarte, CA, USA.
authors.forename: Joycelynne M
authors.initials: JM
authors.lastname: Palmer
authors.affiliation: Division of Biostatistics, Department of Information Sciences, City of Hope National Medical Center, Duarte, CA, USA.
authors.forename: Ni-Chun
authors.initials: NC
authors.lastname: Tsai
authors.affiliation: Division of Biostatistics, Department of Information Sciences, City of Hope National Medical Center, Duarte, CA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Dagis
authors.affiliation: Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
authors.forename: Auayporn
authors.initials: A
authors.lastname: Nademanee
authors.affiliation: Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine, City of Hope National Medical Center, Duarte, CA, USA.
authors.forename: Shirong
authors.initials: S
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001596:Benzylamines; D001803:Blood Transfusion; D003131:Combined Modality Therapy; D000080027:Cyclams; D018450:Disease Progression; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D012074:Remission Induction; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor
keywords: Hodgkin lymphoma; autologous stem cell transplant; peripheral blood stem cell mobilization and collection; plerixafor