SUCCESSFUL PERIPHERAL BLOOD STEM CELL MOBILIZATION WITH A COST-EFFICIENT FIXED SINGLE-DOSE PLERIXAFOR SCHEDULE IN POOR MOBILIZERS
(Abstract release date: 05/19/16)
EHA Library. Greil C. 06/09/16; 135062; PB2162
Dr. Christine Greil
Contributions
Contributions
Abstract
Abstract: PB2162
Type: Publication Only
Background
Collection of hematopoietic stem cells (HSC) from the peripheral blood (PB) is routinely conducted prior to high-dose chemotherapy and autologous transplantation. Despite safety and efficiency of current apheresis procedures including mobilizing chemotherapy and granulocyte colony-stimulating factor (G-CSF), there is still a significant rate of mobilization failures due to different patient-dependent factors necessitating additional agents like plerixafor. A standardized strategy for its application in poor stem cell mobilizers is still lacking.
Aims
To evaluate the efficacy of a cost-efficient fixed single-dose of plerixafor in poor mobilizers on successful HSC mobilization.
Methods
We analyzed 46 patients who underwent autologous HSC transplantation at our academic center between 2011 and 2015 and received plerixafor because they were expected to be poor mobilizers due to low counts of CD34+ cells in PB samples prior to apheresis or after a first apheresis day with insufficient yield or as a rescue strategy after insufficient harvest with previous mobilizing chemotherapy. We examined CD34+ cell counts in PB and in apheresis products to identify those patients who were able to collect a sufficient CD34+ cell count for transplantation after a single application of plerixafor.
Results
Plerixafor could be safely administered, leading in 83% and 48% to apheresis yields of >2 and >4x106 CD34+ cells/kg body weight (bw) and correlating with median CD34+ PB cell counts of 8.0 and 17.8/µl, respectively. Of note, 35/46 (76%) patients showed a substantial benefit of plerixafor vs. G-CSF alone, with increased PB CD34+ cells (13.3 vs. 4.7/µl, p=0.0001) prior to apheresis and 4-fold higher CD34+ cell numbers per single apheresis (1.2 vs. 0.3x106 CD34+/kg bw, respectively, p=0.00005). A patient subset of 24% had <5/µl PB CD34+ cells before plerixafor application and profited less from additional plerixafor administration.
Conclusion
As the number of patients with extensive pretreatment, including new immunomodulatory drugs and with long disease courses will even increase in the future, it is highly important to develop selection criteria for patients with expected benefit of additional plerixafor application, also with regard to cost efficiency. Our data suggest that most patients in preemptive and rescue settings with <5/µl CD34+ cells detectable in PB may fail to substantially benefit and should therefore be carefully selected, whereas those with >5/µl PB CD34+ cells can greatly benefit of a single application with median CD34+ apheresis yield increases of 2.9 and median total apheresis collections of 4.6 x 106/kg bw.
Session topic: E-poster
Keyword(s): Mobilization, Stem cell collection
Type: Publication Only
Background
Collection of hematopoietic stem cells (HSC) from the peripheral blood (PB) is routinely conducted prior to high-dose chemotherapy and autologous transplantation. Despite safety and efficiency of current apheresis procedures including mobilizing chemotherapy and granulocyte colony-stimulating factor (G-CSF), there is still a significant rate of mobilization failures due to different patient-dependent factors necessitating additional agents like plerixafor. A standardized strategy for its application in poor stem cell mobilizers is still lacking.
Aims
To evaluate the efficacy of a cost-efficient fixed single-dose of plerixafor in poor mobilizers on successful HSC mobilization.
Methods
We analyzed 46 patients who underwent autologous HSC transplantation at our academic center between 2011 and 2015 and received plerixafor because they were expected to be poor mobilizers due to low counts of CD34+ cells in PB samples prior to apheresis or after a first apheresis day with insufficient yield or as a rescue strategy after insufficient harvest with previous mobilizing chemotherapy. We examined CD34+ cell counts in PB and in apheresis products to identify those patients who were able to collect a sufficient CD34+ cell count for transplantation after a single application of plerixafor.
Results
Plerixafor could be safely administered, leading in 83% and 48% to apheresis yields of >2 and >4x106 CD34+ cells/kg body weight (bw) and correlating with median CD34+ PB cell counts of 8.0 and 17.8/µl, respectively. Of note, 35/46 (76%) patients showed a substantial benefit of plerixafor vs. G-CSF alone, with increased PB CD34+ cells (13.3 vs. 4.7/µl, p=0.0001) prior to apheresis and 4-fold higher CD34+ cell numbers per single apheresis (1.2 vs. 0.3x106 CD34+/kg bw, respectively, p=0.00005). A patient subset of 24% had <5/µl PB CD34+ cells before plerixafor application and profited less from additional plerixafor administration.
Conclusion
As the number of patients with extensive pretreatment, including new immunomodulatory drugs and with long disease courses will even increase in the future, it is highly important to develop selection criteria for patients with expected benefit of additional plerixafor application, also with regard to cost efficiency. Our data suggest that most patients in preemptive and rescue settings with <5/µl CD34+ cells detectable in PB may fail to substantially benefit and should therefore be carefully selected, whereas those with >5/µl PB CD34+ cells can greatly benefit of a single application with median CD34+ apheresis yield increases of 2.9 and median total apheresis collections of 4.6 x 106/kg bw.
Session topic: E-poster
Keyword(s): Mobilization, Stem cell collection
Abstract: PB2162
Type: Publication Only
Background
Collection of hematopoietic stem cells (HSC) from the peripheral blood (PB) is routinely conducted prior to high-dose chemotherapy and autologous transplantation. Despite safety and efficiency of current apheresis procedures including mobilizing chemotherapy and granulocyte colony-stimulating factor (G-CSF), there is still a significant rate of mobilization failures due to different patient-dependent factors necessitating additional agents like plerixafor. A standardized strategy for its application in poor stem cell mobilizers is still lacking.
Aims
To evaluate the efficacy of a cost-efficient fixed single-dose of plerixafor in poor mobilizers on successful HSC mobilization.
Methods
We analyzed 46 patients who underwent autologous HSC transplantation at our academic center between 2011 and 2015 and received plerixafor because they were expected to be poor mobilizers due to low counts of CD34+ cells in PB samples prior to apheresis or after a first apheresis day with insufficient yield or as a rescue strategy after insufficient harvest with previous mobilizing chemotherapy. We examined CD34+ cell counts in PB and in apheresis products to identify those patients who were able to collect a sufficient CD34+ cell count for transplantation after a single application of plerixafor.
Results
Plerixafor could be safely administered, leading in 83% and 48% to apheresis yields of >2 and >4x106 CD34+ cells/kg body weight (bw) and correlating with median CD34+ PB cell counts of 8.0 and 17.8/µl, respectively. Of note, 35/46 (76%) patients showed a substantial benefit of plerixafor vs. G-CSF alone, with increased PB CD34+ cells (13.3 vs. 4.7/µl, p=0.0001) prior to apheresis and 4-fold higher CD34+ cell numbers per single apheresis (1.2 vs. 0.3x106 CD34+/kg bw, respectively, p=0.00005). A patient subset of 24% had <5/µl PB CD34+ cells before plerixafor application and profited less from additional plerixafor administration.
Conclusion
As the number of patients with extensive pretreatment, including new immunomodulatory drugs and with long disease courses will even increase in the future, it is highly important to develop selection criteria for patients with expected benefit of additional plerixafor application, also with regard to cost efficiency. Our data suggest that most patients in preemptive and rescue settings with <5/µl CD34+ cells detectable in PB may fail to substantially benefit and should therefore be carefully selected, whereas those with >5/µl PB CD34+ cells can greatly benefit of a single application with median CD34+ apheresis yield increases of 2.9 and median total apheresis collections of 4.6 x 106/kg bw.
Session topic: E-poster
Keyword(s): Mobilization, Stem cell collection
Type: Publication Only
Background
Collection of hematopoietic stem cells (HSC) from the peripheral blood (PB) is routinely conducted prior to high-dose chemotherapy and autologous transplantation. Despite safety and efficiency of current apheresis procedures including mobilizing chemotherapy and granulocyte colony-stimulating factor (G-CSF), there is still a significant rate of mobilization failures due to different patient-dependent factors necessitating additional agents like plerixafor. A standardized strategy for its application in poor stem cell mobilizers is still lacking.
Aims
To evaluate the efficacy of a cost-efficient fixed single-dose of plerixafor in poor mobilizers on successful HSC mobilization.
Methods
We analyzed 46 patients who underwent autologous HSC transplantation at our academic center between 2011 and 2015 and received plerixafor because they were expected to be poor mobilizers due to low counts of CD34+ cells in PB samples prior to apheresis or after a first apheresis day with insufficient yield or as a rescue strategy after insufficient harvest with previous mobilizing chemotherapy. We examined CD34+ cell counts in PB and in apheresis products to identify those patients who were able to collect a sufficient CD34+ cell count for transplantation after a single application of plerixafor.
Results
Plerixafor could be safely administered, leading in 83% and 48% to apheresis yields of >2 and >4x106 CD34+ cells/kg body weight (bw) and correlating with median CD34+ PB cell counts of 8.0 and 17.8/µl, respectively. Of note, 35/46 (76%) patients showed a substantial benefit of plerixafor vs. G-CSF alone, with increased PB CD34+ cells (13.3 vs. 4.7/µl, p=0.0001) prior to apheresis and 4-fold higher CD34+ cell numbers per single apheresis (1.2 vs. 0.3x106 CD34+/kg bw, respectively, p=0.00005). A patient subset of 24% had <5/µl PB CD34+ cells before plerixafor application and profited less from additional plerixafor administration.
Conclusion
As the number of patients with extensive pretreatment, including new immunomodulatory drugs and with long disease courses will even increase in the future, it is highly important to develop selection criteria for patients with expected benefit of additional plerixafor application, also with regard to cost efficiency. Our data suggest that most patients in preemptive and rescue settings with <5/µl CD34+ cells detectable in PB may fail to substantially benefit and should therefore be carefully selected, whereas those with >5/µl PB CD34+ cells can greatly benefit of a single application with median CD34+ apheresis yield increases of 2.9 and median total apheresis collections of 4.6 x 106/kg bw.
Session topic: E-poster
Keyword(s): Mobilization, Stem cell collection
{{ help_message }}
{{filter}}