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Neutropenic fever during peripheral blood progenitor cell mobilization is associated with decreased CD34+ cell collection and increased apheresis collection days
Author(s) -
Khouri Jack,
Rybicki Lisa,
Majhail Navneet,
Kalaycio Matt,
Copelan Edward,
Pohlman Brad,
Hill Brian,
Dean Robert,
Lazaryan Aleksandr,
Hamilton Betty,
Andresen Steven,
Sobecks Ronald,
Bolwell Brian,
Liu Hien
Publication year - 2018
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21605
Subject(s) - medicine , apheresis , etoposide , granulocyte colony stimulating factor , lymphoma , cd34 , leukapheresis , gastroenterology , chemotherapy , surgery , immunology , stem cell , platelet , biology , genetics
Background Peripheral blood progenitor cell (PBPC) mobilization with chemotherapy in addition to Granulocyte‐Colony Stimulating Factor (G‐CSF) improves cell collection compared to G‐CSF alone; however, it is associated with increased risk of neutropenic fever (NF). Methods We analyzed risk factors for post‐priming NF and NF association with autologous stem cell transplant outcomes. Between 1998 and 2008, 593 adult patients with lymphoma underwent PBPC mobilization with etoposide and G‐CSF. Results Median age was 51 years (range 18–77) and 372 (63%) were male. Diagnoses were 457 (77%) non‐Hodgkin lymphoma and 136 (23%) Hodgkin lymphoma. Of 554 (93%) transplanted patients, majority were in complete or partial remission at time of transplant (88%). Overall, 141 (24%) patients were hospitalized for NF. Nine patients (6%) had bacteremia, 4 (3%) had pneumonia, 2 (<1%) had herpes simplex viral infections, and the remaining 126 (90%) had no identified infection source. NF patients had lower likelihood of proceeding to transplant (86% vs. 96%, P < .001), lower CD34+ cell dose collection (median 7.23 × 106 CD34+ cells/kg vs. 8.98 × 106 CD34+ cells/kg, P = .002), and were more likely to require > 4 days of apheresis (48% vs. 37%, P < .001). NF was associated with a higher 30‐day readmission rate following transplant hospitalization (17% vs. 9%, P = .012). Conclusion NF during etoposide priming is associated with lower likelihood of proceeding to transplant, lower CD34+ cell dose collection, more apheresis days required for collection and a higher 30‐day readmission rate following transplant discharge.