A comparison of four leukapheresis methods to harvest an optimal dose of CD34+ cells: A single center experience.
Humans
Hematopoietic Stem Cell Mobilization
/ methods
Leukapheresis
/ methods
Cyclams
Hematopoietic Stem Cell Transplantation
Granulocyte Colony-Stimulating Factor
Retrospective Studies
Transplantation, Autologous
Heterocyclic Compounds
Benzylamines
Multiple Myeloma
/ diagnosis
Antigens, CD34
/ metabolism
Immunologic Factors
CD34+ cell yield
apheresis
high-volume leukapheresis
plerixafor
transplant
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
revised:
22
08
2022
received:
18
03
2022
accepted:
22
08
2022
pubmed:
29
8
2022
medline:
15
11
2022
entrez:
28
8
2022
Statut:
ppublish
Résumé
Chemokine receptor CXCR4 antagonist plerixafor (Px) as well as high volume (HV) leukapheresis have been shown to reduce hematopoietic stem progenitor cell (HSPC) mobilization failure rates. However, no direct comparisons of such methods currently exists. We compared the HSPC collection yield based on basal peripheral blood CD34+ cell numbers in patients diagnosed with multiple myeloma or non-Hodgkin's lymphoma undergoing autologous stem cell transplantation in a retrospective chart review. The leukapheresis methods used included HV versus regular volume (RV) with or without Px. There were 116 patients in the study group while the historical control group had 34 patients. Control group underwent RV leukapheresis without Px. Addition of Px or HV in the study group failed to display significant improvement in CD34+ cell collection yield; however, when basal CD34+ cell numbers were taken into account, both Px + RV and HV without Px increased CD34+ cell collection yield. The collection failure rates of HV without Px group were comparable to Px + RV when the basal CD34+ cell numbers were over 20/μl. Of interest, multivariate linear regression analysis did not detect any significant difference between HV versus Px + RV or other leukapheresis methods in CD34 yields or collection failure rates from a single collection after controlling for other factors (sex, age, or underlying disease). In multivariate analysis, pre apheresis CD34+ cell number was significantly and positively associated with the CD34+ cell yields from a single apheresis. In our studies, the majority of patients can be rescued without Px by HV alone as a potential cost saving approach. In summary, trend in our studies reflects that both Px and HV are capable of reducing the mobilization failure rates except the poorest mobilizers, which will need to be validated in larger studies.
Sections du résumé
BACKGROUND
BACKGROUND
Chemokine receptor CXCR4 antagonist plerixafor (Px) as well as high volume (HV) leukapheresis have been shown to reduce hematopoietic stem progenitor cell (HSPC) mobilization failure rates. However, no direct comparisons of such methods currently exists.
METHODS AND MATERIALS
METHODS
We compared the HSPC collection yield based on basal peripheral blood CD34+ cell numbers in patients diagnosed with multiple myeloma or non-Hodgkin's lymphoma undergoing autologous stem cell transplantation in a retrospective chart review. The leukapheresis methods used included HV versus regular volume (RV) with or without Px. There were 116 patients in the study group while the historical control group had 34 patients.
RESULTS AND CONCLUSIONS
CONCLUSIONS
Control group underwent RV leukapheresis without Px. Addition of Px or HV in the study group failed to display significant improvement in CD34+ cell collection yield; however, when basal CD34+ cell numbers were taken into account, both Px + RV and HV without Px increased CD34+ cell collection yield. The collection failure rates of HV without Px group were comparable to Px + RV when the basal CD34+ cell numbers were over 20/μl. Of interest, multivariate linear regression analysis did not detect any significant difference between HV versus Px + RV or other leukapheresis methods in CD34 yields or collection failure rates from a single collection after controlling for other factors (sex, age, or underlying disease). In multivariate analysis, pre apheresis CD34+ cell number was significantly and positively associated with the CD34+ cell yields from a single apheresis. In our studies, the majority of patients can be rescued without Px by HV alone as a potential cost saving approach. In summary, trend in our studies reflects that both Px and HV are capable of reducing the mobilization failure rates except the poorest mobilizers, which will need to be validated in larger studies.
Substances chimiques
Cyclams
0
Granulocyte Colony-Stimulating Factor
143011-72-7
Heterocyclic Compounds
0
Benzylamines
0
Antigens, CD34
0
Immunologic Factors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
711-718Informations de copyright
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Attal M, Harousseau JL, Facon T, et al. Single versus double autologous stem cell transplantation for multiple myeloma. N Eng J Med. 2003;349:2495-2502.
Vose JM, Anderson JR, Kessinger A, et al. High dose chemotherapy and autologous hematopoietic stem cell transplantation for aggressive non-Hodgkin's lymphoma. J Clin Oncol. 1993;11:1846-1851.
Bensinger W, Appelbaum F, Rowley S, et al. Factors that influence collection and engraftment of autologous peripheral-blood stem cells. J Clin Oncol. 1995;13:2547-2555.
Benedetti G, Patoia L, Giglietti A, Alessio M, Pelicci P, Grignani F. Very large amounts of peripheral blood progenitor cells eliminate severe thrombocytopenia after high-dose melphalan in advanced breast cancer patients. Bone Marrow Transplant. 1999;24:971-979.
Weaver CH, Hazelton B, Birch R, et al. An analysis of engraftment kinetics as a function of the CD34 content of peripheral blood progenitor cell collections in 692 patients after the administration of myeloablative chemotherapy. Blood. 1995;86:3961-3969.
Ketterer N, Salles G, Raba M, et al. High CD34(+) cell counts decrease hematologic toxicity of autologous peripheral blood progenitor cell transplantation. Blood. 1998;91:3148-3155.
Philpott NJ, Scopes J, Marsh JC, Gordon-Smith EC, Gibson FM. Increased apoptosis in aplastic anaemia bone marrow progenitor cells: possible pathophysiological significance. Exp Hematol. 1995;23:1642-1648.
Wuchter P, Ran D, Bruckner T, et al. Poor mobilization of hematopoietic stem cells - definitions, incidence, risk factors, and impact on outcome of autologous transplantation. Biol Blood Marrow Transplant. 2010;16:490-499.
Pusic I, Jiang SY, Landua S, et al. Impact of mobilization and remobilization strategies on achieving sufficient stem cell yields for autologous transplantation. Biol Blood Marrow Transplant. 2008;14:1045-1056.
Wood WA, Whitley J, Brown PM, et al. Effectiveness of etoposide chemomobilization in lymphoma patients undergoing auto-SCT. Bone Marrow Transplant. 2013;48:771-776.
Russell N, Douglas K, Ho AD, et al. Plerixafor and granulocyte colony-stimulating factor for first-line steady-state autologous peripheral blood stem cell mobilization in lymphoma and multiple myeloma: results of the prospective PREDICT trial. Haematologica. 2013;98:172-178.
Giralt S, Stadtmauer E, Harousseau J, et al. International myeloma working group (IMWG) consensus statement and guidelines regarding the current status of stem cell collection and high-dose therapy for multiple myeloma and the role of plerixafor (AMD 3100). Leukemia. 2009;23:1904-1912.
Fontana S, Groebli R, Leibundgut K, Pabst T, Zwicky C, Taleghani BM. Progenitor cell recruitment during individualized high-flow, very-large-volume apheresis for autologous transplantation improves collection efficiency. Transfusion. 2006;46:1408-1416.
Smolowicz AG, Villman K, Tidefelt U. Large-volume apheresis for the harvest of peripheral blood progenitor cells for autologous transplantation. Transfusion. 1997;37:188-192.
Humpe A, Riggert J, Munzel U, Köhler M. A prospective, randomized, sequential crossover trial of large-volume versus normal-volume leukapheresis procedures: effects on serum electrolytes, platelet counts, and other coagulation measures. Transfusion. 2000;40:368-374.
Giralt S, Costa L, Schriber J, et al. Optimizing autologous stem cell mobilization strategies to improve patient outcomes: consensus and guidelines and recommendations. Biol Blood Marrow Transplant. 2014;20:295-308.
Dubrovsky L, Wong EC, Perez-Albuerne E, et al. CD34+ collection efficiency as a function of blood volumes processed in pediatric autologous peripheral blood stem cell collection. J Clin Apher. 2011;26(3):131-137.
Vishnu P, Roy V, Paulsen A, Zubair AC. Efficacy and cost-benefit analysis of risk-adaptive use of plerixafor for autologous hematopoietic progenitor cell mobilization. Transfusion. 2012;52:55-62.