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Prognostic factors for re-mobilization using plerixafor and granulocyte colony-stimulating factor (G-CSF) in patients with malignant lymphoma or multiple myeloma previously failing mobilization with G-CSF with or without chemotherapy: the Korean multicenter retrospective study.

 Jin Seok Kim  ;  Dok Hyun Yoon  ;  Seonyang Park  ;  Sung-Soo Yoon  ;  Seok-Goo Cho  ;  Chang-Ki Min  ;  Je-Jung Lee  ;  Deok-Hwan Yang  ;  Jae-Yong Kwak  ;  Hyeon-Seok Eom  ;  Won Seog Kim  ;  Hawk Kim  ;  Young Rok Do  ;  Joon Ho Moon  ;  Jihye Lee  ;  Cheolwon Suh 
 ANNALS OF HEMATOLOGY, Vol.95(4) : 603-611, 2016 
Journal Title
Issue Date
Adult ; Female ; Granulocyte Colony-Stimulating Factor/administration & dosage* ; Heterocyclic Compounds/administration & dosage* ; Humans ; Lymphoma/diagnosis* ; Lymphoma/drug therapy* ; Lymphoma/epidemiology ; Male ; Middle Aged ; Multiple Myeloma/diagnosis* ; Multiple Myeloma/drug therapy* ; Multiple Myeloma/epidemiology ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies ; Treatment Failure ; Young Adult
Granulocyte colony-stimulating factor ; Malignant lymphoma ; Mobilization ; Multiple myeloma ; Plerixafor ; Prognostic factor
Plerixafor in combination with granulocyte colony-stimulating factor (G-CSF) has been shown to improve the rates of successful peripheral blood stem cell (PBSC) mobilization in patients with malignant lymphoma or multiple myeloma (MM) who experienced prior failure of PBSC mobilization. We evaluated the mobilization results of re-mobilization using plerixafor and G-CSF in insufficiently mobilizing patients. Forty-four patients with lymphoma (n = 29) or MM (n = 15) were included in the study. The median age was 50 (range, 24-64) years. Previous mobilization regimens were chemotherapy with G-CSF (n = 28), including cyclophosphamide with G-CSF (n = 15), and G-CSF only (n = 16). All patients with lymphoma achieved at least partial response (PR) before the mobilization, including 13 complete responses (CRs). Eleven patients with MM achieved at least PR and four patients with MM were in stable disease before mobilization. The median number of apheresis was 3 (range, 1-6). The median yield of PBSC collections was 3.41 (0.13-38.11) × 10(6) CD34(+) cells/kg. Thirty-four (77.3 %) patients had successful collections defined as at least 2 × 10(6) CD34(+) cells/kg. The rate of successful collections was not different between the two underlying diseases (79.3 % in lymphoma and 73.3 % in MM). Of the entire cohort, 38 (86.4 %) of patients went on to receive an autologous transplant. Previous long-term use of high-risk drugs (>4 cycles use of alkylating agents, platinum-containing agents, or thalidomide) (HR 10.8, 95 % CI 1.1-110.0, P = 0.043) and low platelet count (<100 × 10(9)/L) 1 day before the first apheresis (HR 27.9, 95 % CI 2.9-273.7, P = 0.004) were independent prognostic factors for predicting failure of PBSC re-mobilization using plerixafor and G-CSF. In conclusion, re-mobilization using plerixafor and G-CSF showed a success rate of 77.3 % in patients with lymphoma or MM who experienced prior failure of PBSC mobilization, and the majority of them underwent autologous transplant. Therefore, plerixafor-based re-mobilization was an effective method in poor mobilizers.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
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