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Single‐center results reporting improved hematopoietic stem cell mobilization success in pediatric and young adult patients with solid tumors and lymphoma
Author(s) -
Koo Jane,
TeusinkCross Ashley,
Davies Stella M.,
Jodele Sonata,
Dandoy Christopher E.
Publication year - 2021
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.29319
Subject(s) - plerixafor , medicine , cxcr4 , cxcr4 antagonist , hematopoietic stem cell transplantation , cd34 , lymphoma , gastroenterology , stem cell , transplantation , granulocyte colony stimulating factor , retrospective cohort study , chemotherapy , surgery , chemokine , receptor , biology , genetics
Background High‐dose chemotherapy with autologous hematopoietic stem cell transplantation (auto‐HSCT) is an established treatment for pediatric and young adult patients with solid tumors and lymphomas. Plerixafor is a CXC chemokine receptor type 4 (CXCR4) antagonist that can be used with granulocyte colony stimulating factor (G‐CSF) to amplify the mobilization of hematopoietic stem cells (HSCs). Methods We performed a retrospective analysis of 167 pediatric solid tumor and lymphoma patients from January 2010 to July 2020 in whom HSCs were mobilized using G‐CSF alone or with plerixafor. Results Thirteen heavily pretreated patients (33.3%) required twice‐daily dosing of G‐CSF compared to five patients (3.9%) in the not heavily pretreated group ( p = .0005). Fourteen heavily pretreated patients (35.9%) required plerixafor compared to four patients (3.1%) in the comparison cohort ( p = .0002). The number of mobilization days was similar between both cohorts, with 5 days (range 3–11 days) in the heavily pretreated group and 5 days (range 3–13 days) in the not heavily pretreated group ( p = .55). The number of harvest days was 2 days (range 1–5 days) in the heavily pretreated group and 1 day (range 1–4 days) in the not heavily pretreated group ( p = .0025). The final cluster of differentiation (CD)34 + /kilogram (kg) count was 9.52 × 10 6 /kg among heavily pretreated patients compared to 34.99 × 10 6 /kg CD34 + cells in the comparison group ( p < .0001). Three heavily pretreated patients (7.7%) failed HSC mobilization. Conclusions Patients at the highest risk for poor HSC mobilization can be successfully treated with more frequent G‐CSF dosing or G‐CSF with plerixafor in a large majority of cases.