Prediction of mobilized hematopoietic stem cell yield in patients with multiple myeloma: Usefulness of whole-body MRI-derived indices.

High-dose chemotherapy followed by autologous stem cell transplant is the mainstay of treatment for multiple myeloma (MM). The purpose of this study was to evaluate the ability of MRI-derived indices to predict mobilized hematopoietic stem cell yield. In this exploratory pilot work, we retrospectively analyzed 38 mobilization procedures for MM. Successful mobilization procedure was defined as a total yield of >4.0×106 CD34+ cells/kg. Univariate and multivariate analyses were performed to identify factors with a significant effect on successful mobilization from among clinical characteristics including number of prior lines of therapy, period from diagnosis to harvest, type of monoclonal protein (M protein); and radiological characteristics including total diffusion volume (tDV), median apparent diffusion coefficient (ADC) of tDV, and mean fat fraction of bone marrow calculated by MRI. Univariate analyses showed that relatively poor mobilization was significantly associated with M protein of Bence-Jones type and with median ADC of tDV (P = 0.02 and P = 0.004, respectively). Multivariate analyses using these two indices showed that median ADC of tDV was a significant predictive factor for adequate mobilization (P = 0.01), with an area under the curve of 0.784 (cutoff value, 1.18×10-3 mm2/s; sensitivity, 72.7%; specificity, 87.5%). The present data indicate that median ADC of tDV is a predictive factor for relatively poor mobilization of hematopoietic stem cells in MM patients undergoing autologous stem cell transplant.

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Copyright: © 2023 Takasu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

M.T.: Kyowa Kirin Co., Ltd., Celgene Co.; T.I.: Research Grant, Chugai Pharmaceutical Co., CSL Behring K.K., Daiichi-Sankyo Co., Eisai Co., Kyowa Kirin Co., Nippon Shinyaku Co., Ono Pharmaceutical Co., Otsuka Pharmaceutical Co., Repertoire Genesis Inc., Sumitomo Dainippon Pharma Co., Takeda Pharmaceutical Co., Zenyaku Kogyo Co.; K.A.: Research Grant, Canon Medical Systems Corporation Research Grant, Hitachi, Ltd. Research Grant, Fujitsu Limited Research Grant, Bayer AG Research Grant, DAIICHI SANKYO Group Research Grant, Eisai Co., Ltd. This does not alter our adherence to PLOS ONE policies on sharing data and materials. T.S., S.K., N.T., A.T., M.I., and T.K. have declared that no competing interests exist.