THE ANALYSIS OF PATIENTS WITH POOR MOBILIZATION AND MOBILIZATION FAILURE: CAN RDW BE A PREDICTIVE FACTOR?
(Abstract release date: 05/19/16)
EHA Library. Aytan P. 06/09/16; 135066; PB2166
Dr. Pelin Aytan
Contributions
Contributions
Abstract
Abstract: PB2166
Type: Publication Only
Background
Autologous hematopoetic stem cell transplantation (AHSCT) has been routinely used in the treatment of hematologic malignancies. Stem cell collection procedure from the patients has been accomplished with apheresis equipments. G-CSF is usually used alone or with chemotherapy for the purpose of the mobilization.
Aims
The aim of the present study is to assess retrospectively the patients who had been mobilized with different chemotherapy protocols between 2012 and 2016 and to analyze the patients with poor mobilization or mobilization failure and to determine the possible causes.
Methods
This study has been planned as a cross sectional study in a center that has been a member of EBMT and had been accreditated by JACIE between the years 2012 and 2016. All the data were obtained from the hospital data bases. Spectra Optia (Terumo BCT, Denver, USA) which utilizes continous flow centrifuge technique was used for the collection of stem cells. Peripheral and product CD 34 counts were done with FACS Canto II (BD Bioscience, USA) device and ISAGE method. Mobilization techniques used in the patients had been planned in accordance to the standart application (SOP number; KIT-KU009) methods. The patients with CD34 counts less than 20 cells/uL had been defined as “poor mobilization” whereas patients with stem cell counts less than 2x106/kg in product had been accepted as “mobilization failure”. In the day of stem cell collection peripheral blood count (Sysmex, XN 1000, Tokyo, Japon) had been performed and RDW, hemoglobin and platelet counts were noted.
Results
In our center there has been a total of 27 poor mobilization cases (8.82%;23 patients) between 2012 and 2016. A total of 279 stem cell apheresis procedures had been performed during the same period and in 35 cases (12.54%) mobilization failure was observed. 5 of the patients in the poor mobilization group had 3 consequtive chemotherapy protocols (1 patient radiotherapy), 12 of them received 2 consequtive and 6 of them received 1 chemotherapy protocolIn this group mobilization was tried to be accomplished with G-CSF alone in 6 patients, with G-CSF and plerixefor in 2 patients and with chemotherapy and G-CSF in 15 patients. For the comparison of RDW, Hb and platelet numbers among the mobilization groups, first day laboratory results of the patients had been used. There were no statistically significant difference with respect to platelet and Hb levels among the groups; however, the RDW was found to be significantly lower in the patients with successfull mobilization when compared with the patients in the poor mobilization and mobilisation failure groups (median [minimum-maximum] values were 15.4(12.08-25.20),16.4 (13.3-21.6) and 16.3(13.5-24.9) in successfully mobilized, poorly mobilized and mobilization failed groups (p=0.029)Mobilization failure was observed during stem cell collection in 6 of the 60 patients in 2012, 5 of 63 patients in 2013, 4 of 44 patients in 2014 and 7 in 49 patients in 2015. The median number of chemotherapy before mobilization procedure was 2 (1-3), and the median platelet levels during peripheral CD34 count was 95500/µL (10000-384000/µL). The median CD34 cell count from the peripheral blood was 9 cell/µL(0-17) and the median percentage of CD34 was 0,03(0,00-0,11).
Conclusion
Our results support the hypothesis that multiple chemotherapy independent from age results in poor mobilization and mobilization failure. RDW was shown to be lower in patients with successfull mobilization compared with poor mobilization or mobilization failure patients. The role of RDW in prediction of mobilization success has to be clarified in further studies.
Session topic: E-poster
Keyword(s): Apheresis, Chemotherapy, Mobilization
Type: Publication Only
Background
Autologous hematopoetic stem cell transplantation (AHSCT) has been routinely used in the treatment of hematologic malignancies. Stem cell collection procedure from the patients has been accomplished with apheresis equipments. G-CSF is usually used alone or with chemotherapy for the purpose of the mobilization.
Aims
The aim of the present study is to assess retrospectively the patients who had been mobilized with different chemotherapy protocols between 2012 and 2016 and to analyze the patients with poor mobilization or mobilization failure and to determine the possible causes.
Methods
This study has been planned as a cross sectional study in a center that has been a member of EBMT and had been accreditated by JACIE between the years 2012 and 2016. All the data were obtained from the hospital data bases. Spectra Optia (Terumo BCT, Denver, USA) which utilizes continous flow centrifuge technique was used for the collection of stem cells. Peripheral and product CD 34 counts were done with FACS Canto II (BD Bioscience, USA) device and ISAGE method. Mobilization techniques used in the patients had been planned in accordance to the standart application (SOP number; KIT-KU009) methods. The patients with CD34 counts less than 20 cells/uL had been defined as “poor mobilization” whereas patients with stem cell counts less than 2x106/kg in product had been accepted as “mobilization failure”. In the day of stem cell collection peripheral blood count (Sysmex, XN 1000, Tokyo, Japon) had been performed and RDW, hemoglobin and platelet counts were noted.
Results
In our center there has been a total of 27 poor mobilization cases (8.82%;23 patients) between 2012 and 2016. A total of 279 stem cell apheresis procedures had been performed during the same period and in 35 cases (12.54%) mobilization failure was observed. 5 of the patients in the poor mobilization group had 3 consequtive chemotherapy protocols (1 patient radiotherapy), 12 of them received 2 consequtive and 6 of them received 1 chemotherapy protocolIn this group mobilization was tried to be accomplished with G-CSF alone in 6 patients, with G-CSF and plerixefor in 2 patients and with chemotherapy and G-CSF in 15 patients. For the comparison of RDW, Hb and platelet numbers among the mobilization groups, first day laboratory results of the patients had been used. There were no statistically significant difference with respect to platelet and Hb levels among the groups; however, the RDW was found to be significantly lower in the patients with successfull mobilization when compared with the patients in the poor mobilization and mobilisation failure groups (median [minimum-maximum] values were 15.4(12.08-25.20),16.4 (13.3-21.6) and 16.3(13.5-24.9) in successfully mobilized, poorly mobilized and mobilization failed groups (p=0.029)Mobilization failure was observed during stem cell collection in 6 of the 60 patients in 2012, 5 of 63 patients in 2013, 4 of 44 patients in 2014 and 7 in 49 patients in 2015. The median number of chemotherapy before mobilization procedure was 2 (1-3), and the median platelet levels during peripheral CD34 count was 95500/µL (10000-384000/µL). The median CD34 cell count from the peripheral blood was 9 cell/µL(0-17) and the median percentage of CD34 was 0,03(0,00-0,11).
Conclusion
Our results support the hypothesis that multiple chemotherapy independent from age results in poor mobilization and mobilization failure. RDW was shown to be lower in patients with successfull mobilization compared with poor mobilization or mobilization failure patients. The role of RDW in prediction of mobilization success has to be clarified in further studies.
Session topic: E-poster
Keyword(s): Apheresis, Chemotherapy, Mobilization
Abstract: PB2166
Type: Publication Only
Background
Autologous hematopoetic stem cell transplantation (AHSCT) has been routinely used in the treatment of hematologic malignancies. Stem cell collection procedure from the patients has been accomplished with apheresis equipments. G-CSF is usually used alone or with chemotherapy for the purpose of the mobilization.
Aims
The aim of the present study is to assess retrospectively the patients who had been mobilized with different chemotherapy protocols between 2012 and 2016 and to analyze the patients with poor mobilization or mobilization failure and to determine the possible causes.
Methods
This study has been planned as a cross sectional study in a center that has been a member of EBMT and had been accreditated by JACIE between the years 2012 and 2016. All the data were obtained from the hospital data bases. Spectra Optia (Terumo BCT, Denver, USA) which utilizes continous flow centrifuge technique was used for the collection of stem cells. Peripheral and product CD 34 counts were done with FACS Canto II (BD Bioscience, USA) device and ISAGE method. Mobilization techniques used in the patients had been planned in accordance to the standart application (SOP number; KIT-KU009) methods. The patients with CD34 counts less than 20 cells/uL had been defined as “poor mobilization” whereas patients with stem cell counts less than 2x106/kg in product had been accepted as “mobilization failure”. In the day of stem cell collection peripheral blood count (Sysmex, XN 1000, Tokyo, Japon) had been performed and RDW, hemoglobin and platelet counts were noted.
Results
In our center there has been a total of 27 poor mobilization cases (8.82%;23 patients) between 2012 and 2016. A total of 279 stem cell apheresis procedures had been performed during the same period and in 35 cases (12.54%) mobilization failure was observed. 5 of the patients in the poor mobilization group had 3 consequtive chemotherapy protocols (1 patient radiotherapy), 12 of them received 2 consequtive and 6 of them received 1 chemotherapy protocolIn this group mobilization was tried to be accomplished with G-CSF alone in 6 patients, with G-CSF and plerixefor in 2 patients and with chemotherapy and G-CSF in 15 patients. For the comparison of RDW, Hb and platelet numbers among the mobilization groups, first day laboratory results of the patients had been used. There were no statistically significant difference with respect to platelet and Hb levels among the groups; however, the RDW was found to be significantly lower in the patients with successfull mobilization when compared with the patients in the poor mobilization and mobilisation failure groups (median [minimum-maximum] values were 15.4(12.08-25.20),16.4 (13.3-21.6) and 16.3(13.5-24.9) in successfully mobilized, poorly mobilized and mobilization failed groups (p=0.029)Mobilization failure was observed during stem cell collection in 6 of the 60 patients in 2012, 5 of 63 patients in 2013, 4 of 44 patients in 2014 and 7 in 49 patients in 2015. The median number of chemotherapy before mobilization procedure was 2 (1-3), and the median platelet levels during peripheral CD34 count was 95500/µL (10000-384000/µL). The median CD34 cell count from the peripheral blood was 9 cell/µL(0-17) and the median percentage of CD34 was 0,03(0,00-0,11).
Conclusion
Our results support the hypothesis that multiple chemotherapy independent from age results in poor mobilization and mobilization failure. RDW was shown to be lower in patients with successfull mobilization compared with poor mobilization or mobilization failure patients. The role of RDW in prediction of mobilization success has to be clarified in further studies.
Session topic: E-poster
Keyword(s): Apheresis, Chemotherapy, Mobilization
Type: Publication Only
Background
Autologous hematopoetic stem cell transplantation (AHSCT) has been routinely used in the treatment of hematologic malignancies. Stem cell collection procedure from the patients has been accomplished with apheresis equipments. G-CSF is usually used alone or with chemotherapy for the purpose of the mobilization.
Aims
The aim of the present study is to assess retrospectively the patients who had been mobilized with different chemotherapy protocols between 2012 and 2016 and to analyze the patients with poor mobilization or mobilization failure and to determine the possible causes.
Methods
This study has been planned as a cross sectional study in a center that has been a member of EBMT and had been accreditated by JACIE between the years 2012 and 2016. All the data were obtained from the hospital data bases. Spectra Optia (Terumo BCT, Denver, USA) which utilizes continous flow centrifuge technique was used for the collection of stem cells. Peripheral and product CD 34 counts were done with FACS Canto II (BD Bioscience, USA) device and ISAGE method. Mobilization techniques used in the patients had been planned in accordance to the standart application (SOP number; KIT-KU009) methods. The patients with CD34 counts less than 20 cells/uL had been defined as “poor mobilization” whereas patients with stem cell counts less than 2x106/kg in product had been accepted as “mobilization failure”. In the day of stem cell collection peripheral blood count (Sysmex, XN 1000, Tokyo, Japon) had been performed and RDW, hemoglobin and platelet counts were noted.
Results
In our center there has been a total of 27 poor mobilization cases (8.82%;23 patients) between 2012 and 2016. A total of 279 stem cell apheresis procedures had been performed during the same period and in 35 cases (12.54%) mobilization failure was observed. 5 of the patients in the poor mobilization group had 3 consequtive chemotherapy protocols (1 patient radiotherapy), 12 of them received 2 consequtive and 6 of them received 1 chemotherapy protocolIn this group mobilization was tried to be accomplished with G-CSF alone in 6 patients, with G-CSF and plerixefor in 2 patients and with chemotherapy and G-CSF in 15 patients. For the comparison of RDW, Hb and platelet numbers among the mobilization groups, first day laboratory results of the patients had been used. There were no statistically significant difference with respect to platelet and Hb levels among the groups; however, the RDW was found to be significantly lower in the patients with successfull mobilization when compared with the patients in the poor mobilization and mobilisation failure groups (median [minimum-maximum] values were 15.4(12.08-25.20),16.4 (13.3-21.6) and 16.3(13.5-24.9) in successfully mobilized, poorly mobilized and mobilization failed groups (p=0.029)Mobilization failure was observed during stem cell collection in 6 of the 60 patients in 2012, 5 of 63 patients in 2013, 4 of 44 patients in 2014 and 7 in 49 patients in 2015. The median number of chemotherapy before mobilization procedure was 2 (1-3), and the median platelet levels during peripheral CD34 count was 95500/µL (10000-384000/µL). The median CD34 cell count from the peripheral blood was 9 cell/µL(0-17) and the median percentage of CD34 was 0,03(0,00-0,11).
Conclusion
Our results support the hypothesis that multiple chemotherapy independent from age results in poor mobilization and mobilization failure. RDW was shown to be lower in patients with successfull mobilization compared with poor mobilization or mobilization failure patients. The role of RDW in prediction of mobilization success has to be clarified in further studies.
Session topic: E-poster
Keyword(s): Apheresis, Chemotherapy, Mobilization
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