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Bilgin YM. Use of Plerixafor for Stem Cell Mobilization in the Setting of Autologous and Allogeneic Stem Cell Transplantations: An Update. J Blood Med 2021; 12:403-412. [PMID: 34104027 PMCID: PMC8180285 DOI: 10.2147/jbm.s307520] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
Mobilization failure is an important issue in stem cell transplantations. Stem cells are yielded from the peripheral blood via apheresis. Granulocyte colony-stimulating factor (G-CSF) is the most commonly used mobilization agent among patients and donors. G-CSF is administered subcutaneously for multiple days. However, patients with mobilization failure cannot receive autologous stem cell transplantation and, therefore, cannot be treated adequately. The incidence rate of mobilization failure among patients is about 6–23%. Plerixafor is a molecule that inhibits the binding of chemokine receptor-4 with stromal-cell-derived factor-1, thereby resulting in the release of CD34+ cells in the peripheral blood. Currently, plerixafor is used in patients with mobilization failure with G-CSF and is administered subcutaneously. Several studies conducted on different clinical settings have shown that plerixafor is effective and well tolerated by patients. However, more studies should be conducted to explore the optimal approach for plerixafor in patients with mobilization failure. The incidence of mobilization failure among donors is lower. However, plerixafor is not approved among donors with mobilization failure. Moreover, several clinical studies in donors have shown a beneficial effect of plerixafor. In addition, the adverse events of plerixafor are mild and transient, which can overcome the adverse events due to G-CSF. This review assessed the current role and effects of plerixafor in stem cell mobilization for autologous and allogeneic stem cell transplantations.
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Affiliation(s)
- Yavuz M Bilgin
- Department of Internal Medicine/Hematology, Admiraal de Ruijter Hospital, Goes, the Netherlands
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2
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Iida S, Ishida T, Horimoto K, Kazama H, Kim H, Crawford B, Teshima T. Medical database analysis of japanese multiple myeloma patients with planned stem cell transplantation (MEDALIST) - a focus on healthcare resource utilization and cost. Int J Hematol 2020; 113:271-278. [PMID: 33063174 DOI: 10.1007/s12185-020-03022-5] [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: 06/03/2020] [Revised: 09/25/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
This study explored the burden associated with stem cell mobilization, with or without cyclophosphamide (CPA), in patients who intended to receive autologous stem cell transplantation (ASCT) for multiple myeloma (MM). A Japanese health care claims database (MDV) was used to analyze the health care resource utilization patterns and medical cost between 2013 and 2016 (pre-plerixafor launch). The patients were further categorized into groups who received granulocyte-colony stimulating factor (G-CSF) alone or G-CSF + CPA group and analyzed in both mobilization and ASCT phases of treatment. Overall, there were more MM patients who were treated with G-CSF + CPA combination therapy than G-CSF alone. Length-of-stay was 1.6 times longer in the combination group during the mobilization phase. A reverse trend was observed during the ASCT phase. Direct cost was approximately 1.2 million yen during the mobilization phase and 2.3 million yen during the ASCT phase, with hospitalization basic fee accounting for the highest proportion in both groups and phases. A substantial amount of healthcare resource and cost was consumed in both phases. This study may serve as a basic reference for further health technology assessment of new medicines such as plerixafor. Further investigation of differences between treatment groups is warranted.
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Affiliation(s)
- Shinsuke Iida
- Department of Hematology and Oncology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | | | | | | | | | - Takanori Teshima
- Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
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3
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Wang J, Tannous BA, Poznansky MC, Chen H. CXCR4 antagonist AMD3100 (plerixafor): From an impurity to a therapeutic agent. Pharmacol Res 2020; 159:105010. [PMID: 32544428 DOI: 10.1016/j.phrs.2020.105010] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/22/2020] [Accepted: 06/07/2020] [Indexed: 02/07/2023]
Abstract
AMD3100 (plerixafor), a CXCR4 antagonist, has opened a variety of avenues for potential therapeutic approaches in different refractory diseases. The CXCL12/CXCR4 axis and its signaling pathways are involved in diverse disorders including HIV-1 infection, tumor development, non-Hodgkin lymphoma, multiple myeloma, WHIM Syndrome, and so on. The mechanisms of action of AMD3100 may relate to mobilizing hematopoietic stem cells, blocking infection of X4 HIV-1, increasing circulating neutrophils, lymphocytes and monocytes, reducing myeloid-derived suppressor cells, and enhancing cytotoxic T-cell infiltration in tumors. Here, we first revisit the pharmacological discovery of AMD3100. We then review monotherapy of AMD3100 and combination use of AMD3100 with other agents in various diseases. Among those, we highlight the perspective of AMD3100 as an immunomodulator to regulate immune responses particularly in the tumor microenvironment and synergize with other therapeutics. All the pre-clinical studies support the clinical testing of the monotherapy and combination therapies with AMD3100 and further development for use in humans.
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Affiliation(s)
- Jingzhe Wang
- Jiangsu Key Laboratory of Clinical Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
| | - Bakhos A Tannous
- Experimental Therapeutics and Molecular Imaging Laboratory, Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA; Harvard Medical School, Boston, MA, 02115, USA
| | - Mark C Poznansky
- Vaccine and Immunotherapy Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA; Harvard Medical School, Boston, MA, 02115, USA
| | - Huabiao Chen
- Experimental Therapeutics and Molecular Imaging Laboratory, Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA; Vaccine and Immunotherapy Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA; Harvard Medical School, Boston, MA, 02115, USA.
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4
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Zhu J. [Thoughts on autologous hematopoietic stem cell transplantation and mobilization in Chinese patients with non Hodgkin's lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:1-4. [PMID: 32023746 PMCID: PMC7357905 DOI: 10.3760/cma.j.issn.0253-2727.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Indexed: 11/05/2022]
Affiliation(s)
- J Zhu
- Department of Lymphoma, Peking University Cancer Hospital, Beijing Institute for Cancer Research, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing 100142, China
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5
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Connelly-Smith LS. Donor Evaluation for Hematopoietic Stem and Progenitor Cell Collection. ADVANCES AND CONTROVERSIES IN HEMATOPOIETIC TRANSPLANTATION AND CELL THERAPY 2020. [PMCID: PMC7123736 DOI: 10.1007/978-3-319-55131-9_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
With the increasing incidence of hematopoietic allogeneic cell transplantation (allo-HCT), the importance of securing a cellular product, safely from a donor, and ensuring that the product is without additional risk to the recipient, continues to be of paramount importance. The evaluation of the donor’s medical eligibility and suitability is designed to identify and limit the risk of transmitting infectious, genetic, or neoplastic diseases to the recipient through the product. It also aims to ensure a maximum level of safety for the donor and informs them of the risks of donation. Several regulatory agencies, national and international registries, and accreditation bodies have facilitated the availability and safe provision of human cells, tissues, and cellular- and tissue-based products not only at local institutions but also through international exchange.
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6
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Lopez-Millan B, Sanchéz-Martínez D, Roca-Ho H, Gutiérrez-Agüera F, Molina O, Diaz de la Guardia R, Torres-Ruiz R, Fuster JL, Ballerini P, Suessbier U, Nombela-Arrieta C, Bueno C, Menéndez P. NG2 antigen is a therapeutic target for MLL-rearranged B-cell acute lymphoblastic leukemia. Leukemia 2019; 33:1557-1569. [PMID: 30635633 PMCID: PMC6755967 DOI: 10.1038/s41375-018-0353-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/15/2018] [Accepted: 11/28/2018] [Indexed: 02/07/2023]
Abstract
B cell acute lymphoblastic leukemia (B-ALL) is the most common childhood cancer, with cure rates of ∼80%. MLL-rearranged (MLLr) B-ALL (MLLr-B-ALL) has, however, an unfavorable prognosis with common therapy refractoriness and early relapse, and therefore new therapeutic targets are needed for relapsed/refractory MLLr-B-ALL. MLLr leukemias are characterized by the specific expression of chondroitin sulfate proteoglycan-4, also known as neuron-glial antigen-2 (NG2). NG2 was recently shown involved in leukemia invasiveness and central nervous system infiltration in MLLr-B-ALL, and correlated with lower event-free survival (EFS). We here hypothesized that blocking NG2 may synergize with established induction therapy for B-ALL based on vincristine, glucocorticoids, and l-asparaginase (VxL). Using robust patient-derived xenograft (PDX) models, we found that NG2 is crucial for MLLr-B-ALL engraftment upon intravenous (i.v.) transplantation. In vivo blockade of NG2 using either chondroitinase-ABC or an anti-NG2-specific monoclonal antibody (MoAb) resulted in a significant mobilization of MLLr-B-ALL blasts from bone marrow (BM) to peripheral blood (PB) as demonstrated by cytometric and 3D confocal imaging analysis. When combined with either NG2 antagonist, VxL treatment achieved higher rates of complete remission, and consequently higher EFS and delayed time to relapse. Mechanistically, anti-NG2 MoAb induces neither antibody-dependent cell-mediated not complement-dependent cytotoxicity. NG2 blockade rather overrides BM stroma-mediated chemoprotection through PB mobilization of MLLr-B-ALL blasts, thus becoming more accessible to chemotherapy. We provide a proof of concept for NG2 as a therapeutic target for MLLr-B-ALL.
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Affiliation(s)
- Belen Lopez-Millan
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain.
| | - Diego Sanchéz-Martínez
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain
| | - Heleia Roca-Ho
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain
| | - Francisco Gutiérrez-Agüera
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain
| | - Oscar Molina
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain
| | - Rafael Diaz de la Guardia
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain
| | - Raúl Torres-Ruiz
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain.,Molecular Cytogenetics Group, Human Cancer Genetics Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Jose Luís Fuster
- Pediatric Hematology and Oncology Section, Hospital Clínico Virgen de la Arrixaca, Murcia, Spain
| | - Paola Ballerini
- Pediatric Hematology, Armand Trousseau Hospital, Paris, France
| | - Ute Suessbier
- Hematology Department, University Hospital-University of Zurich, Zurich, Switzerland
| | - Cesar Nombela-Arrieta
- Hematology Department, University Hospital-University of Zurich, Zurich, Switzerland
| | - Clara Bueno
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain. .,Centro de Investigacion Biomedica en Red-Oncología (CIBERONC), Zurich, Switzerland.
| | - Pablo Menéndez
- Department of Biomedicine, School of Medicine, Josep Carreras Leukemia Research Institute, University of Barcelona, Barcelona, Spain. .,Centro de Investigacion Biomedica en Red-Oncología (CIBERONC), Zurich, Switzerland. .,Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
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7
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Doberschuetz N, Soerensen J, Bonig H, Willasch A, Rettinger E, Pfirrmann V, Salzmann-Manrique E, Schäfer R, Klingebiel T, Bader P, Jarisch A. Mobilized peripheral blood stem cell apheresis via Hickman catheter in pediatric patients. Transfusion 2019; 59:1061-1068. [PMID: 30610749 DOI: 10.1111/trf.15113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Autologous stem cell transplantation remains an integral treatment tool for certain childhood malignancies. In children, a central venous catheter is typically necessary to provide adequate flow rates for preparative apheresis. In this study, the feasibility and efficiency of collecting CD34+ cells via an indwelling Hickman catheter, preimplanted for chemotherapy, instead of placing an additional temporary central venous catheter was evaluated. STUDY DESIGN AND METHODS Forty-eight pediatric leukaphereses for autologous hematopoietic stem cell transplantation using Spectra Optia MNC, Version 3.0 were reviewed. We compared preimplanted Hickman catheters with a temporary Shaldon catheter, inserted for apheresis. Apheresis was considered successful if a dose of 2 × 106 CD34+ peripheral blood stem cells/kg BW was achieved. RESULTS In 43 (89.6%) of the 48 patients, a Hickman catheter was used for leukapheresis. Only 5 patients (10.4%) received a temporary Shaldon catheter. In both groups, apheresis was performed without apparent adverse reactions. The dose of collected CD34+ peripheral blood stem cells was 12.7 × 106 (range, 2.3-70.7 × 106 ) cells/kg BW in the Hickman group and 16.2 × 106 (range, 3.8-48.4 × 106 ) cells/kg BW in the Shaldon group, showing no statistically significant difference (p = 0.58). In both groups, the primary endpoint of a minimal CD34+ cell concentration of 2 × 106 cells/kg BW was achieved at a maximum of two leukapheresis sessions. Apheresis efficacy was further confirmed by the collection efficiency of 40.2% in the Hickman group and 27.8% in the Shaldon group (p = 0.32). CONCLUSION These data indicate the reliable feasibility and efficacy of mobilized apheresis via an indwelling Hickman catheter. In light of this, the routine insertion of a dialysis catheter for the purpose of leukapheresis should be critically reconsidered.
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Affiliation(s)
- Nora Doberschuetz
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Jan Soerensen
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Halvard Bonig
- Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany.,Department for Cellular Therapeutics, German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt am Main, Germany
| | - Andre Willasch
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Eva Rettinger
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Verena Pfirrmann
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Emilia Salzmann-Manrique
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Richard Schäfer
- Department for Cellular Therapeutics, German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt am Main, Germany
| | - Thomas Klingebiel
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Peter Bader
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Andrea Jarisch
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
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8
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Abstract
Transplants using peripheral blood hemopoietic stem/progenitor (PBHS) cells are widely performed for the treatment of patients with hematologic disorders in routine practice and clinical trials. Although the process from mobilization to infusion of PBHS cells has been mostly established, optimal conditions for each process remain undetermined. Adverse reactions caused by PBHS cell infusions have not been systematically recorded. In transplants using PBHS cells, a number of problems still exist. In this section, the current status of and future perspectives regarding PBHS cells are described.
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Affiliation(s)
- Kazuo Muroi
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
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9
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Rosenfeld-Keidar H, Eshel R, Pinhasov A, Bitan M, Edelman S, Broitman M, Dvir R, Sadot E, Levin D, Manisterski M, Berger-Achituv S, Elhasid R. Significant correlation between peripheral blood CD34+ cell count in children prior to aphaeresis and CD34+ cell yield following aphaeresis: A single-center experience. Pediatr Transplant 2018; 22:e13150. [PMID: 29498177 DOI: 10.1111/petr.13150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/30/2017] [Indexed: 12/30/2022]
Abstract
Numerous adults' studies demonstrated that preaphaeresis CD34+ cells significantly correlate with the number of CD34+ cells collected by the aphaeresis procedure. Equivalent studies in children are scarce. We studied retrospectively 92 aphaeresis procedures performed following chemotherapy (44) or in steady state (48) in 60 pediatric patients (40 males, 20 females), median age of 7.5 years. Aphaeresis procedures were performed using a SPECTRA Optica (TERUMOBCT) continuous flow cell separator. CD34+ cell concentrations were assessed using flow cytometry. A highly significant correlation between peripheral CD34 cell count on the day of aphaeresis and CD34 cell yield per kg (R2 = .824, P < .0001) was demonstrated. A higher preaphaeresis CD34 cell count was demonstrated in patients with higher preaphaeresis white blood cell count, in patients with brain tumors, and in patients who received chemotherapy as part of their mobilization protocol. A threshold number of 20 peripheral CD34+ cell/μL was found to predict harvesting of 3 × 106 stem cells/kg, and 30 peripheral CD34+ cell/μL for harvesting of 5 × 106 stem cells/kg. This significant correlation between peripheral CD34 cell count and CD34 cell yield, and the threshold number of peripheral CD34 found to predict adequate harvesting can be useful in planning the optimal time for aphaeresis in children.
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Affiliation(s)
- Hila Rosenfeld-Keidar
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Rinat Eshel
- Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Aviva Pinhasov
- Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Menachem Bitan
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sabina Edelman
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Marcela Broitman
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Rina Dvir
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Efraim Sadot
- Department of Pediatric Intensive Care Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dror Levin
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Manisterski
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sivan Berger-Achituv
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronit Elhasid
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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10
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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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11
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Greil C, Ihorst G, Kiote-Schmidt C, Hildenbeutel S, Kühbach K, Bosse R, Duyster J, Engelhardt M, Wäsch R. Stem cell mobilization in poor mobilizers with multiple myeloma or lymphoma before and after introduction of plerixafor: a single-center comparative analysis using a cost-efficient single fixed-dose schedule. Leuk Lymphoma 2017; 59:1722-1725. [PMID: 29081261 DOI: 10.1080/10428194.2017.1393673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Christine Greil
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
| | - Gabriele Ihorst
- b Clinical Trials Unit, Faculty of Medicine , University of Freiburg , Freiburg , Germany
| | - Chrissoula Kiote-Schmidt
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
| | - Steffi Hildenbeutel
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
| | - Katja Kühbach
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
| | - Roland Bosse
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
| | - Justus Duyster
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
| | - Monika Engelhardt
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
| | - Ralph Wäsch
- a Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine , Medical Center - University of Freiburg , Freiburg , Germany
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12
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Greil C, Kiote-Schmidt C, Fink G, Ihorst G, Hildenbeutel S, Bosse R, Duyster J, Engelhardt M, Wäsch R. Successful peripheral blood stem cell mobilization with a cost-efficient single fixed-dose plerixafor schedule in poor mobilizers. Leuk Lymphoma 2017; 58:1849-1858. [DOI: 10.1080/10428194.2016.1271946] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Christine Greil
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Chrissoula Kiote-Schmidt
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Geertje Fink
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Steffi Hildenbeutel
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Roland Bosse
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Justus Duyster
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Monika Engelhardt
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralph Wäsch
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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13
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Duarte FB, Prado BDPA, Vieira GMM, Costa LJ. Mobilization of hematopoietic progenitor cells for autologous transportation: consensus recommendations. Rev Assoc Med Bras (1992) 2016; 62 Suppl 1:10-15. [PMID: 27982316 DOI: 10.1590/1806-9282.62.suppl1.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Selected patients with certain hematological malignancies and solid tumors have the potential to achieve long-term survival with autologous hematopoietic progenitor cell transplant. The collection of these cells in peripheral blood avoids multiple bone marrow aspirations, results in faster engraftment and allows treatment of patients with infection, fibrosis, or bone marrow hypocellularity. However, for the procedure to be successful, it is essential to mobilize a sufficient number of progenitor cells from the bone marrow into the blood circulation. Therefore, a group of Brazilian experts met in order to develop recommendations for mobilization strategies adapted to the reality of the Brazilian national health system, which could help minimize the risk of failure, reduce toxicity and improve the allocation of financial resources.
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Affiliation(s)
- Fernando Barroso Duarte
- Service of Hematology and Hematopoietic Cell Transplantation, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Brazil
| | | | | | - Luciano J Costa
- Department of Bone Marrow Transplantation and Cell Therapy Program, Department of Medicine and UAB-CCC, Birmingham, AL, USA
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Exercise as an Adjuvant Therapy for Hematopoietic Stem Cell Mobilization. Stem Cells Int 2016; 2016:7131359. [PMID: 27123008 PMCID: PMC4830735 DOI: 10.1155/2016/7131359] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/03/2016] [Accepted: 02/07/2016] [Indexed: 12/13/2022] Open
Abstract
Hematopoietic stem cell transplant (HSCT) using mobilized peripheral blood hematopoietic stem cells (HSPCs) is the only curative strategy for many patients suffering from hematological malignancies. HSPC collection protocols rely on pharmacological agents to mobilize HSPCs to peripheral blood. Limitations including variable donor responses and long dosing protocols merit further investigations into adjuvant therapies to enhance the efficiency of HSPCs collection. Exercise, a safe and feasible intervention in patients undergoing HSCT, has been previously shown to robustly stimulate HSPC mobilization from the bone marrow. Exercise-induced HSPC mobilization is transient limiting its current clinical potential. Thus, a deeper investigation of the mechanisms responsible for exercise-induced HSPC mobilization and the factors responsible for removal of HSPCs from circulation following exercise is warranted. The present review will describe current research on exercise and HSPC mobilization, outline the potential mechanisms responsible for exercise-induced HSPC mobilization, and highlight potential sites for HSPC homing following exercise. We also outline current barriers to the implementation of exercise as an adjuvant therapy for HSPC mobilization and suggest potential strategies to overcome these barriers.
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Ozen M, Gunduz M, Topcuoglu P, Toprak SK, Dalva K, Gurman G, Ilhan O. The effect of age on peripheral stem cell mobilization in healthy donors, single center experience. J Clin Apher 2016; 32:16-20. [PMID: 26958783 DOI: 10.1002/jca.21457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/16/2016] [Accepted: 02/16/2016] [Indexed: 11/10/2022]
Abstract
PURPOSE Peripheral stem cell transplantation is used as a life-saving therapeutic option in hematological malignancies. As previously established, most hematological malignancies are seen in the elderly population. Therefore, possible HLA-identical sibling donors of elderly patients are generally of an advanced age. In this study, we aimed to evaluate the effect of old age on stem cell mobilization and quality in older adult healthy sibling donors. MATERIALS AND METHODS Between 2006 and 2014, we evaluated 38 healthy donors aged ≥55 years. The granulocyte-colony stimulating factor (G-CSF) analogs were used at a dose of 5 µg/kg/day and administered subcutaneously twice a day for five days. CD34+ cells were estimated in the peripheral blood before collection of the apheresis product. The National Marrow Donor Program selects healthy unrelated donors if they are younger than 60 years. Therefore, we compared the product quality in donors over the age of 60 to that in donors aged 60 years or less. RESULTS We collected sufficient products from all the donors with one to three apheresis procedures. No serious complication was detected in all donors. Reaching the target CD34+ cell count in one day were detected in 83% of younger and 79% of older donors (P = NS). Collected CD34+ cells x10e6/recipient body weight (kg) was same and 5.1 in the groups (P = NS). There were no correlation between the donor age and these parameters. CONCLUSION Healthy donor apheresis in older adults can be performed effectively and possible donors should be evaluated regardless of their age. J. Clin. Apheresis 32:16-20, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Mehmet Ozen
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Gunduz
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Pervin Topcuoglu
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Selami K Toprak
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Klara Dalva
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gunhan Gurman
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Osman Ilhan
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
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