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CD34+ cell mobilization, blood graft composition, and posttransplant recovery in myeloma patients compared to non‐Hodgkinʼs lymphoma patients: results of the prospective multicenter GOA study
Author(s) -
Turunen Antti,
Partanen Anu,
Valtola Jaakko,
Ropponen Antti,
Siitonen Timo,
Kuittinen Outi,
Kuitunen Hanne,
Putkonen Mervi,
Sankelo Marja,
Keskinen Leena,
Savolainen EevaRiitta,
Pyörälä Marja,
Kuittinen Taru,
Silvennoinen Raija,
Penttilä Karri,
Sikiö Anu,
Vasala Kaija,
Mäntymaa Pentti,
Pelkonen Jukka,
Varmavuo Ville,
Jantunen Esa
Publication year - 2020
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.15820
Subject(s) - medicine , multiple myeloma , lymphoma , cd34 , apheresis , mobilization , autologous stem cell transplantation , gastroenterology , prospective cohort study , plerixafor , surgery , stem cell , platelet , cxcr4 , history , genetics , chemokine , receptor , archaeology , biology
BACKGROUND Autologous stem cell transplantation is an established treatment option for patients with multiple myeloma (MM) or non‐Hodgkinʼs lymphoma (NHL). STUDY DESIGN AND METHODS In this prospective multicenter study, 147 patients with MM were compared with 136 patients with NHL regarding the mobilization and apheresis of blood CD34+ cells, cellular composition of infused blood grafts, posttransplant recovery, and outcome. RESULTS Multiple myeloma patients mobilized CD34+ cells more effectively (6.3 × 10 6 /kg vs. 3.9 × 10 6 /kg, p = 0.001). The proportion of poor mobilizers (peak blood CD34+ cell count <20 × 10 6 /L) was higher in NHL patients (15% vs. 3%, p < 0.001). Plerixafor was added to rescue the mobilization failure in 17 MM patients (12%) and in 35 NHL patients (26%; p = 0.002). The infused grafts contained more natural killer (NK) and CD19+ cells in MM patients. Blood platelet and NK‐cell counts were higher in MM patients posttransplant. Early treatment‐related mortality was low in both groups, but NHL patients had a higher late (>100 days) nonrelapse mortality (NRM; 6% vs. 0%, p = 0.003). CONCLUSIONS Non‐Hodgkinʼs lymphoma and MM patients differ in terms of mobilization of CD34+ cells, graft cellular composition, and posttransplant recovery. Thus, the optimal graft characteristics may also be different.