1
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Taenaka R, Takigawa K, Okamura K, Obara T, Nishimura N, Kohno K, Aoki K, Ogawa R. Addition of plerixafor for mobilization of stem cells with bortezomib is feasible in dialysis-dependent multiple myeloma. Transfus Apher Sci 2021; 60:103279. [PMID: 34563457 DOI: 10.1016/j.transci.2021.103279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
Plerixafor and bortezomib have recently been used in autologous stem cell collection to increase the amount of stem cells collected. However, no reports have described the combined use of plerixafor and bortezomib in cases of dialysis-dependent multiple myeloma. The dialysis-dependent multiple myeloma patient in the present study had a small amount of CD34-positive cells with plerixafor and filgrastim, and also with bortezomib and cyclophosphamide. However, by adding plerixafor to bortezomib and cyclophosphamide, collected CD34-positive cells were increased six-fold compared to the previous day. These findings suggest that the combination of plerixafor and bortezomib may be effective in those patients.
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Affiliation(s)
- Ryutaro Taenaka
- Department of Hematology and Oncology, JCHO Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan.
| | - Ken Takigawa
- Department of Hematology, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka-city, Fukuoka, Japan
| | - Kazuhiro Okamura
- Department of Nephrology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka, Japan
| | - Teppei Obara
- Department of Hematology and Oncology, JCHO Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Naoaki Nishimura
- Department of Pharmacy, JCHO Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Kentaro Kohno
- Department of Hematology and Oncology, JCHO Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Kenichi Aoki
- Department of Hematology and Oncology, JCHO Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Ryosuke Ogawa
- Department of Hematology and Oncology, JCHO Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
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2
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Kong JH, Hu Y, Kong SY, Lee SN, Eom HS, Lee H, Lee E, Shim H. Analysis of laboratory parameters for optimal autologous peripheral blood stem cell collection from lymphoma and myeloma patients. J Clin Apher 2020; 36:135-142. [PMID: 33247855 DOI: 10.1002/jca.21855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/27/2020] [Accepted: 11/04/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Peripheral blood stem cell (PBSC) collection is important for successful hematopoietic stem cell transplantation. This study aimed to investigate the laboratory parameters associated with the optimal timing of autologous PBSC collection from lymphoma and multiple myeloma patients. METHODS We retrospectively evaluated data from 1105 PBSC apheresis procedures performed on 379 adult patients at the National Cancer Center between June 2005 and December 2019. Laboratory parameters, including cutoff values for the number of hematopoietic progenitor cells (HPCs) and circulating CD34+ cells, were analyzed to determine their association with CD34+ cell yield. RESULTS The pre-apheresis HPC and CD34+ cell count were statistically significant variables associated with harvested CD34+ cell in lymphoma and MM patients. The optimal cutoff values were 18 × 106 /L for pre-HPC count (66.8% sensitivity, 66.4% specificity) and 11/μL for pre-CD34+ cell count (85.8% sensitivity, 87.2% specificity), to achieve CD34+ cell yields ≥ 1.0 × 106 /kg for each apheresis procedure. Moreover, the optimal cutoff values were 23 × 106 /L for pre-HPC count (71.0% sensitivity, 69.0% specificity) and 18/μL for pre-CD34+ cell count (87.5% sensitivity, 86.3% specificity) to achieve CD34+ cell yields ≥ 2.0 × 106 /kg for each apheresis procedure. CONCLUSION HPC count is a potential surrogate marker for monitoring the starting time for PBSC collection. Applying cutoff values for the number of HPC and CD34+ cells may be clinically useful for optimizing the timing of PBSC collection.
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Affiliation(s)
- Jung Hee Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Youmi Hu
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Sun-Young Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Se-Na Lee
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Hyeon-Seok Eom
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, South Korea
| | - Hyewon Lee
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, South Korea
| | - Eunyoung Lee
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, South Korea
| | - Hyoeun Shim
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
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3
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Tey SR, Robertson S, Lynch E, Suzuki M. Coding Cell Identity of Human Skeletal Muscle Progenitor Cells Using Cell Surface Markers: Current Status and Remaining Challenges for Characterization and Isolation. Front Cell Dev Biol 2019; 7:284. [PMID: 31828070 PMCID: PMC6890603 DOI: 10.3389/fcell.2019.00284] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/01/2019] [Indexed: 12/12/2022] Open
Abstract
Skeletal muscle progenitor cells (SMPCs), also called myogenic progenitors, have been studied extensively in recent years because of their promising therapeutic potential to preserve and recover skeletal muscle mass and function in patients with cachexia, sarcopenia, and neuromuscular diseases. SMPCs can be utilized to investigate the mechanisms of natural and pathological myogenesis via in vitro modeling and in vivo experimentation. While various types of SMPCs are currently available from several sources, human pluripotent stem cells (PSCs) offer an efficient and cost-effective method to derive SMPCs. As human PSC-derived cells often display varying heterogeneity in cell types, cell enrichment using cell surface markers remains a critical step in current procedures to establish a pure population of SMPCs. Here we summarize the cell surface markers currently being used to detect human SMPCs, describing their potential application for characterizing, identifying and isolating human PSC-derived SMPCs. To date, several positive and negative markers have been used to enrich human SMPCs from differentiated PSCs by cell sorting. A careful analysis of current findings can broaden our understanding and reveal potential uses for these surface markers with SMPCs.
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Affiliation(s)
- Sin-Ruow Tey
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, United States
| | - Samantha Robertson
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, United States
| | - Eileen Lynch
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, United States
| | - Masatoshi Suzuki
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, United States.,The Stem Cell and Regenerative Medicine Center, University of Wisconsin, Madison, WI, United States
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4
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Agarwal P, Tejwani N, Pathak A, Kumar D, Agrawal N, Mehta A. Benefits of Pre-harvest Peripheral Blood CD34 Counts Guided Single Dose Therapy with PLERIXAFOR in Autologous Hematopoietic Stem Cell Transplantation: A Retrospective Study at a Tertiary Care Institute in India. Indian J Hematol Blood Transfus 2018; 35:72-76. [PMID: 30828151 DOI: 10.1007/s12288-018-0979-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/29/2018] [Indexed: 02/01/2023] Open
Abstract
Peripheral blood is a convenient source of stem cells for hematopoietic stem cell transplantation. However, in autologous transplants, the harvest failure rates are high because of inadequate mobilization using G-CSF alone. Plerixafor is a potent mobilizer when used with G-CSF. However, its routine use is limited by high cost. This is a retrospective study done at a tertiary care oncology centre in India. All the harvest records were analyzed between Jan 2015 and Nov 2017. May 2016 onwards pre-harvest peripheral blood CD34 count was done in all cases of autologous transplants on day 4 of G-CSF therapy and they were given a single dose of Plerixafor if counts were < 20 cell per cumm. The results were compared amongst various groups. A total of 321 cases were analyzed. 172/321 were allogenic transplant cases of which 5% (n = 7) failed to achieve a target live stem cell dose of > 2 million per kg of the recipient. The overall failure rate in autologous group (n = 149) was 27% (n = 41) (p ≤ 0.001 auto vs. allo). The failure rate was higher (36%, n = 28/77) when no intervention with Plerixafor was done. The overall failure rate in the group treated with pre-harvest 34 count based single dose therapy of Plerixafor was 18% (n = 13/72, p = 0.01). However, within this intervention group, the patients who had pre-harvest peripheral blood CD34 above the desired cutoff had a higher failure rate of 21% (p = 0.13). Pre-harvest CD34 count based intervention with Plerixafor help optimizing the cost.
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Affiliation(s)
- Poojan Agarwal
- 1Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India
| | - Narender Tejwani
- 1Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India
| | - Amardeep Pathak
- 2Department of Pathology, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India
| | - Dushyant Kumar
- 2Department of Pathology, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India
| | - Narendra Agrawal
- 3Department of Hematology, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India
| | - Anurag Mehta
- 1Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi India
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5
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Villa CH, Porturas T, Sell M, Wall M, DeLeo G, Fetters J, Mignono S, Irwin L, Hwang WT, O'Doherty U. Rapid prediction of stem cell mobilization using volume and conductivity data from automated hematology analyzers. Transfusion 2017; 58:330-338. [PMID: 29230822 DOI: 10.1111/trf.14449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/02/2017] [Accepted: 10/05/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Rapid analytics to predict circulating hematopoietic stem cells are valuable for optimal management of mobilization, particularly for the use of newer and costly mobilization agents such as plerixafor. STUDY DESIGN AND METHODS We used stepwise, linear multiple regression modeling applied to cell population data collected by routine hematology analyzers (Beckman Coulter DxH 800) on patients undergoing autologous stem cell collection (n = 131). Beta coefficients were used to derive a formula for a stem cell index (SCI). We then tested the correlation of SCI with stem cell counts and performance of the SCI as a predictor of poor mobilization with external validation in a separate cohort (n = 183). RESULTS The SCI correlated strongly with CD34 counts by flow cytometry (r = 0.8372 in the development cohort, r = 0.8332 in the external validation cohort) and compares favorably with other rapid stem cell enumerating technologies. In the external validation cohort, the SCI performed well as a predictor (receiver operating characteristic area under the curve, 0.9336) of poor mobilization (CD34 count < 10), with a sensitivity of 72% and a specificity of 93%. When prevalence of poor mobilization was 33%, this resulted in a positive predictive value of 83% and a negative predictive value of 87%. The SCI also showed promise in tracking responses to plerixafor administration. CONCLUSION The findings demonstrate the utility of the cell population data collected by hematology analyzers to provide rapid data beyond standard complete blood counts, particularly for stem cell count prediction, requiring no additional reagents, specimen, or instrumentation.
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Affiliation(s)
- Carlos H Villa
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Thomas Porturas
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Mary Sell
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Mark Wall
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Gene DeLeo
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Jenna Fetters
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Sam Mignono
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Leah Irwin
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
| | - Wei-Ting Hwang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Una O'Doherty
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
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6
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Grommé M, Russcher H, Braakman E, Klinkspoor JH, Dobber JA, de Greef I, de Wit NC. Multicenter study to evaluate a new enumeration method for hematopoietic stem cell collection management. Transfusion 2017; 57:1949-1955. [DOI: 10.1111/trf.14183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 02/10/2017] [Accepted: 02/16/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Monique Grommé
- Department of Internal Medicine; Division of Haematology, Erasmus Medical Centre; Rotterdam the Netherlands
| | - Henk Russcher
- Clinical Chemistry, Erasmus Medical Centre; Rotterdam the Netherlands
| | - Eric Braakman
- Department of Hematology; Erasmus Medical Centre; Rotterdam the Netherlands
| | - J. Henriëtte Klinkspoor
- Laboratory for General Clinical Chemistry, Academic Medical Center; Amsterdam the Netherlands
| | - Johan A. Dobber
- Laboratory for Specialized Haematology; Academic Medical Center; Amsterdam the Netherlands
| | - Inge de Greef
- Department of Hematology; Erasmus Medical Centre; Rotterdam the Netherlands
| | - Norbert C.J. de Wit
- Central Diagnostic Laboratory; Maastricht University Medical Center; Maastricht the Netherlands
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7
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Abstract
Peripheral blood stem cell collection is an effective approach to obtain a hematopoietic graft for stem cell transplantation. Developing hematopoietic stem/progenitor cell (HSPC) mobilization methods and collection algorithms have improved efficiency, clinical outcomes, and cost effectiveness. Differences in mobilization mechanisms may change the HSPC content harvested and result in different engraftment kinetics and complications. Patient-specific factors can affect mobilization. Incorporating these factors in collection algorithms and improving assays for evaluating mobilization further extend the ability to obtain sufficient HSPCs for hematopoietic repopulation. Technological advance and innovations in leukapheresis have improved collection efficiency and reduced adverse effects.
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Affiliation(s)
- Yen-Michael S Hsu
- Pathology and Laboratory Medicine, Transfusion Medicine and Cellular Therapy, Weill Cornell Medical College, 525 East 68th Street, Box 251, New York, NY 10065, USA.
| | - Melissa M Cushing
- Transfusion Medicine and Cellular Therapy, Weill Cornell Medical College, 525 East 68th Street, Box 251, M09, New York, NY 10065, USA.
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8
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Asfour I, Afify H, Elkourashy S, Ayoub M, Kamal G, Gamal M, Elgohary G. CXCR4 (CD184) expression on stem cell harvest and CD34 + cells post-transplant. Hematol Oncol Stem Cell Ther 2017; 10:63-69. [PMID: 28282510 DOI: 10.1016/j.hemonc.2017.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 01/11/2017] [Accepted: 01/27/2017] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES/BACKGROUND CXCR4 is a receptor for stromal-derived factor-1 (SDF-1), a molecule that has a chemotactic activity for lymphocytes and is important in homing of hematopoietic stem cells to their adult marrow. We evaluated the CXCR4 (CD184) expression in the harvest cells and in the post-transplant bone marrow (BM) and its relation to engraftment, as determined by the consensus criteria and chimerism. METHODS This is a prospective study which included 30 patients undergoing hematopoietic stem cell transplantation; 15 patients received autograft and 15 patients received allograft on dates between January 2012 and May 2014. We assessed CD184 (CXCR4) using flow cytometry in the harvest cells together with post-transplant BM assessment on Day 28 and Day 90 for complete morphologic, molecular studies, and detection of CD184 expression on CD34+ cells with chimerism studies on total peripheral blood mononuclear cells. RESULTS Diagnoses of the enrolled patients were as follows: seven (24.1%) with acute myeloid leukemia, eight (27.6%) with multiple myeloma, four (13.8%) with acute lymphoblastic leukemia, three (10.3%) with non-Hodgkin lymphoma, two (6.9%) with myelodysplastic syndromes, two (6.9%) with aplastic anemia, two (6.9%) with chronic myeloid leukemia, one (3.4%) with Hodgkin lymphoma, and one (3.4%) with plasmacytomas. One patient died and was excluded from the study because there were not enough data about engraftment. There was no statistical significance between the level of CD184 in stem cell harvest and the prediction of successful engraftment (p>0.05) as well as in Day 28 BM sample (p>0.05), whereas there was a statistical significance between the level of CD184 in Day 90 BM sample and the occurrence of successful engraftment (p=0.002). CONCLUSION SDF-1/CXCR4 axis plays a crucial role in engraftment; however, more studies are warranted to assess their expression post-transplant. Evaluating the ligand (chemokine, SDF-1) or its receptor (CXCR4) may serve as potential surrogate markers for assessment of engraftment.
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Affiliation(s)
- Inas Asfour
- Hematology/BMT Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Hanaa Afify
- Hematopathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Shaza Elkourashy
- Hematology/BMT Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Maryse Ayoub
- Hematology/BMT Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Gihan Kamal
- Hematology/BMT Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Mary Gamal
- Hematology/BMT Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Ghada Elgohary
- Hematology/BMT Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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9
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Wu CY, Chiou TJ, Liu CY, Lin FC, Lin JS, Hung MH, Hsiao LT, Yen CC, Gau JP, Yen HJ, Hung GY, Hsu HC, Tzeng CH, Liu JH, Yu YB. Decision-tree algorithm for optimized hematopoietic progenitor cell-based predictions in peripheral blood stem cell mobilization. Transfusion 2016; 56:2042-51. [PMID: 27232662 DOI: 10.1111/trf.13666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/02/2016] [Accepted: 04/07/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Enumerating hematopoietic progenitor cells (HPCs) by using an automated hematology analyzer is a rapid, inexpensive, and simple method for predicting a successful harvest compared with enumerating circulating CD34+ cells. However, the optimal HPC cutoff count and the indicating factors to be considered for improved predicting have not yet been determined. STUDY DESIGN AND METHODS Between 2007 and 2012, a total of 189 consecutive patients who proceeded to peripheral blood stem cell (PBSC) harvesting were retrospectively recruited. Baseline characteristics were analyzed to identify the risk factors for a failed harvest, which were defined as less than 2 × 10(6) CD34+ cells/kg. Variables identified by multivariate logistic regression and correlation analysis for predicting a successful harvest were subjected to classification and regression tree (CART) analysis. RESULTS PBSCs were successfully harvested in 154 (81.5%) patients. An age of at least 60 years, a diagnosis of a solid tumor, at least five prior chemotherapy cycles, prior radiotherapy, and mobilization with granulocyte-colony-stimulating factor alone or high-dose cyclophosphamide were independent baseline predictors of poor mobilization. In CART analysis, patients with zero to two host risk factors and either higher HPC (≥28 × 10(6) /L) or mononuclear cell (MNC; ≥3.5 × 10(9) /L) counts were categorized as good mobilizers and their harvest success rate was 92.3%. By contrast, 30.3% of harvests were adequate in the patients with three to five host risk factors and lower HPC and MNC counts. CONCLUSION A CART algorithm incorporating host predictors and HPC and MNC counts improves predictions in a successful harvest and might reduce the necessity of monitoring peripheral CD34+ cells.
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Affiliation(s)
- Chia-Yun Wu
- Division of Hematology, Department of Medicine.,Division of Medical Oncology, Department of Oncology.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeon-Jye Chiou
- Division of Hematology, Department of Medicine.,Division of Transfusion Medicine, Department of Medicine.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Yu Liu
- Division of Medical Oncology, Department of Oncology.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Feng-Chang Lin
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jeong-Shi Lin
- Division of Hematology, Department of Medicine.,Division of Transfusion Medicine, Department of Medicine.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Man-Hsin Hung
- Division of Medical Oncology, Department of Oncology.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Tsai Hsiao
- Division of Hematology, Department of Medicine.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chueh-Chuan Yen
- Division of Medical Oncology, Department of Oncology.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jyh-Pyng Gau
- Division of Hematology, Department of Medicine.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiu-Ju Yen
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Giun-Yi Hung
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hui-Chi Hsu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Saint Mary's Hospital Luodong, Yilan, Taiwan
| | - Cheng-Hwai Tzeng
- Division of Hematology, Department of Medicine.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jing-Hwang Liu
- Division of Hematology, Department of Medicine.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yuan-Bin Yu
- Division of Hematology, Department of Medicine.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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10
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Yu JT, Cheng SB, Yang Y, Chang KH, Hwang WL, Teng CLJ. Circulating hematopoietic progenitors and CD34(+) cells predicted successful hematopoietic stem cell harvest in myeloma and lymphoma patients: experiences from a single institution. J Blood Med 2016; 7:5-11. [PMID: 26917978 PMCID: PMC4751903 DOI: 10.2147/jbm.s95679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Previous studies have shown that the numbers of both circulating hematopoietic progenitor cell (HPC) and CD34+ cell are positively correlated with CD34+ cell harvest yield. However, the minimal numbers of both circulating HPCs and CD34+ cells required for performing an efficient hematopoietic stem cell (HSC) harvest in lymphoma and myeloma patients have not been defined in our institution. Patients and methods Medical records of 50 lymphoma and myeloma patients undergoing peripheral blood HSC harvest in our institution were retrospectively reviewed. The minimal and optimal HSC harvest yield required for the treatment was considered to be ≥2×106 CD34+ cells/kg and ≥5×106 CD34+ cells/kg, respectively. Results The minimally required or optimal HSC yield obtained was not influenced by age (≥60 years), sex, underlying malignancies, disease status, multiple rounds of chemotherapy, or history of radiotherapy. The numbers of both circulating HPC and CD34+ cell were higher in patients with minimally required HSC yields (P=0.000 for HPC and P=0.000 for CD34+ cell) and also in patients with optimal HSC yields (P=0.011 for HPC and P=0.006 for CD34+ cell). The cell count cutoff for obtaining minimally required HSC harvest was determined to be 20/mm3 for HPCs and 10/mm3 for CD34+ cells. Furthermore, the cell count cutoff for obtaining optimal HSC harvest was determined to be 60/mm3 for HPCs and 35/mm3 for CD34+ cells. Conclusion A total of 60/mm3 of HPCs and 35/mm3 of CD34+ cells in peripheral blood predicted optimal HSC harvest in lymphoma and myeloma patients.
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Affiliation(s)
- Jui-Ting Yu
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Tunghai University, Taichung, Taiwan, Republic of China; Division of Hematology/Medical Oncology, Tungs' Taichung MetroHarbor Hospital, Tunghai University, Taichung, Taiwan, Republic of China
| | - Shao-Bin Cheng
- Division of General Surgery, Department of Surgery, Tunghai University, Taichung, Taiwan, Republic of China
| | - Youngsen Yang
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Tunghai University, Taichung, Taiwan, Republic of China
| | - Kuang-Hsi Chang
- Department of Medical Research and Education, Taichung Veterans General Hospital, Tunghai University, Taichung, Taiwan, Republic of China
| | - Wen-Li Hwang
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Tunghai University, Taichung, Taiwan, Republic of China
| | - Chieh-Lin Jerry Teng
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Tunghai University, Taichung, Taiwan, Republic of China; Department of Life Science, Tunghai University, Taichung, Taiwan, Republic of China; School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China
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11
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Costa LJ, Nista EJ, Buadi FK, Lacy MQ, Dispenzieri A, Kramer CP, Edwards KH, Kang Y, Gertz MA, Stuart RK, Kumar S. Prediction of poor mobilization of autologous CD34+ cells with growth factor in multiple myeloma patients: implications for risk-stratification. Biol Blood Marrow Transplant 2013; 20:222-8. [PMID: 24211319 DOI: 10.1016/j.bbmt.2013.11.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 11/04/2013] [Indexed: 01/09/2023]
Abstract
It is unknown whether clinical characteristics can successfully predict which multiple myeloma (MM) patients would be poor mobilizers with growth factor (GF) alone so they can be assigned to mobilization with chemotherapy + GF or GF + plerixafor. MM patients (N = 477) who underwent autologous mobilization with GF were retrospectively reviewed and assigned into training and validation cohorts. In multiple regression analysis, age, platelet count at time of mobilization, type of GF utilized, and extent of exposure to lenalidomide independently correlated with peripheral blood (PB)-CD34+ and were integrated in a predicting score (PS) for poor mobilizers, defined as PB-CD34+ < 20/mm(3) 4 days after initiation of GF. There was no correlation between institution, gender, time between diagnosis, and mobilization or plasma cells in the bone marrow at time of mobilization and PBCD34+. The PS cut-off found in the training cohort to have 90% sensitivity for prediction of poor mobilizers performed with 89.7% sensitivity but only 34.8% specificity in the validation cohort. Conversely, the PS cut-off developed to have 90% specificity performed with 86.9% specificity but only 37% sensitivity. We conclude that clinical characteristics identifiable before initiation of mobilization should not be used to stratify MM patients for different mobilization strategies.
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Affiliation(s)
- Luciano J Costa
- Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.
| | - Elizabeth J Nista
- Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
| | - Francis K Buadi
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Martha Q Lacy
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Angela Dispenzieri
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Cindy P Kramer
- Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
| | - Kathy H Edwards
- Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
| | - Yubin Kang
- Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Morie A Gertz
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Robert K Stuart
- Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Shaji Kumar
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota
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