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Factors affecting successful mobilization with plerixafor: an I talian prospective survey in 215 patients with multiple myeloma and lymphoma
Author(s) -
Lanza Francesco,
Lemoli Roberto M.,
Olivieri Attilio,
Laszlo Daniele,
Martino Massimo,
Specchia Giorgina,
Pavone Vincenzo,
Imola Manuela,
Pasini Annalisa,
Milone Giuseppe,
Scortechini Ilaria,
Todisco Elisabetta,
Guggiari Elena,
Cascavilla Nicola,
Martinelli Giovanni,
Rambaldi Alessandro,
Bosi Alberto
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12265
Subject(s) - plerixafor , medicine , mobilization , multiple myeloma , chemotherapy , leukapheresis , melphalan , lenalidomide , oncology , surgery , stem cell , cxcr4 , genetics , chemokine , receptor , archaeology , biology , cd34 , history
Background Although the efficacy of plerixafor in peripheral blood stem cell ( PBSC ) mobilization has been explored in several studies, factors associated with successful plerixafor mobilization after administration of granulocyte–colony‐stimulating factor ( G ‐ CSF ), with or without chemotherapy, have not been investigated. We analyzed data on PBSC mobilization from a large Italian database of lymphoma and myeloma plerixafor‐treated patients. Study Design and Methods Two endpoints were established to define successful mobilization: patients with at least 2 × 10 6 CD 34+ cells/kg collected by three leukapheresis procedures and patients achieving a peak count of at least 20 × 10 6 CD 34+ cells/ L during mobilization. Results Plerixafor achieved successful mobilization in both predicted (n = 64) and proven poor mobilizers ( PMs ; n = 143), classified according to the G ruppo I taliano Trapianto di M idollo O sseo ( GITMO ) criteria. Successful mobilization was independent of type of mobilization (steady state or chemotherapy); age; sex; disease; number or type of chemotherapy regimens preceding plerixafor; radiation therapy; prior treatment with melphalan, carmustine, lenalidomide, and radioimmune conjugates; and laboratory variables. Multivariate analysis identified previous fludarabine treatment and premobilization platelet count as predictors of successful mobilization. Conclusion This large, prospective, nationwide study confirmed plerixafor efficacy for mobilizing PBSCs when added to G ‐ CSF with or without chemotherapy. Plerixafor can overcome negative effects of most predictors of poor mobilization to achieve satisfactory harvest both in predicted and proven PM .