Engraftment after autologous hematopoietic stem cell transplantation in patients mobilized with Plerixafor: A retrospective, multicenter study of a large series of patients. (June 2021)

• Record Type: Journal Article
• Authors: Antelo, M. Luisa; Altuna, Ane; Gimeno, J. José; Ferreiro, J. Javier; Amunárriz, Cristina; Mateos, J. José; Zalba, Saioa; Alkorta, Aitziber; Rifón, José; Arroyo, J. Luis; Uresandi, Amaia; Moreno, J. Antonio; Nájera, M. Josefa; Pinzón, Sergio; García, Alejandro; Vallejo, J. Carlos
• Is Part Of: Transfusion and apheresis science. Volume 60:Number 3(2021)
• Publication Date: 2021-06
• Subjects: Autologous stem cell transplant -- Plerixafor -- Hematopoietic stem cell mobilization -- Mobilization failure -- Engraftment; Blood -- Transfusion -- Periodicals; Hemapheresis -- Periodicals; 615.39
• DOI: 10.1016/j.transci.2021.103130
• Languages: English
• ISSNs: 1473-0502

Abstract

Highlights: Plerixafor (PLX) enhances hematopoietic stem-cell mobilization for transplantation. Data on the quality of engraftment after mobilization with PLX is presented. In a large series, PLX allowed transplantation of 86 % poorly mobilized patients. Optimal engraftment was generally evident 100 days after transplantation. Engraftment efficiency was optimal for different causes of mobilization failure. Abstract: Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored. Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT. The median number of PLX days to reach the stem cell collection goal (≥2 × 10 6 CD34 + cells/kg) was 1 (range 1–4) and the median PLX administration time before apheresis was 11 h (range 1–18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1–5) and the mean number of CD34 + cells collected was 2.95 × 10 6 /kg (range 0–30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported. The median time to achieve an absolute neutrophil count (ANC) >500/μL was 11 days (range 3–31) and the median time to platelet recovery >20 × 10 3 /μL was 13 days (range 5–69). At 100 days after auto-HCT, the platelet count was 137 × 10 9 /L (range 7–340), the ANC was 2.3 × 10 9 /L (range 0.1–13.0), and the hemoglobin concentration was 123 g/L (range 79–165). PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34 + cell concentration on day +4 or low CD34 + cell yield on apheresis.