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Clinical outcomes of multiple myeloma patients who undergo autologous hematopoietic stem cell transplant with G‐CSF or G‐CSF and plerixafor mobilized grafts
Author(s) -
Shah Harsh,
Kim Seongho,
Singh Paramveer,
Alavi Asif,
Ratanatharathorn Voravit,
Ayash Lois,
Uberti Joseph,
Deol Abhinav
Publication year - 2020
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.25672
Subject(s) - plerixafor , medicine , multiple myeloma , gastroenterology , hematopoietic stem cell transplantation , granulocyte colony stimulating factor , autologous stem cell transplantation , stem cell , surgery , transplantation , chemotherapy , urology , cxcr4 , biology , chemokine , receptor , genetics
Impact of Plerixafor (P) mobilized stem cells on immune reconstitution, such as absolute lymphocyte count at day 30 (ALC30), and on long‐term outcomes of Multiple Myeloma (MM) patients undergoing autologous stem cell transplant (ASCT) has not been well established. We evaluated total of 469 patients mobilized with G‐CSF (G) alone, and 141 patients mobilized with G‐CSF plus plerixafor (G+ P). Patients only received plerixafor if they had peripheral blood CD34 + blood count <20/μL on first planned day of collection. Primary endpoint, ALC30, was 1.3 K/μL (range, 0.1‐4.5) and 1.2 K/μL (range, 0.1‐5.1) for G and G + P, respectively ( P =. 61). The median PFS was 2.5 years (95% CI, 2.1‐3.2) and 2.8 years (95% CI, 2.0‐3.3) for G and G + P, respectively (HR: 1.13; 95% CI, 0.84‐1.50; P = .42). The median OS was 6.1 years (95% CI, 4.6‐NR) for G group compared to 3.7 years (95% CI, 3.2‐NR) for the G + P group (HR: 1.64; 95% CI, 1.12‐2.40; P = .01). The median follow‐up time for OS was 2.53 years (95% CI, 2.13‐2.99) and 1.59 years (95% CI, 1.17‐2.02) for G and G+ P group, respectively. In this large retrospective analysis of MM patients mobilized with G‐CSF vs G‐CSF + P, there was no significant difference in lymphocyte recovery or PFS. There was an overall survival difference in patients who were poor mobilizers and could not be mobilized with G‐CSF alone.