Preemptive plerixafor injection added to pegfilgrastim after chemotherapy in non-Hodgkin lymphoma patients mobilizing poorly

被引：0
作者：
A. Partanen
J. Valtola
A. Ropponen
K. Vasala
K. Penttilä
L. Ågren
M. Pyörälä
T. Nousiainen
T. Selander
P. Mäntymaa
J. Pelkonen
V. Varmavuo
E. Jantunen
机构：
[1] Kuopio University Hospital,Department of Medicine
[2] University of Eastern Finland,Department of Clinical Microbiology
[3] Central Hospital of Central Finland,Department of Oncology
[4] Central Hospital of Savonlinna,Department of Medicine
[5] The Finnish Medicines Agency,Department of Medicine
[6] North Karelia Central Hospital,Science Service Center
[7] Kuopio University Hospital,Department of Medicine
[8] Laboratory Center of Eastern Finland,undefined
[9] Kymenlaakso Central Hospital,undefined
来源：
Annals of Hematology | 2017年 / 96卷
关键词：
Preemptive plerixafor; Pegfilgrastim; Non-Hodgkin lymphoma; CD34; cell mobilization; Graft composition; Post-transplant recovery; Outcome;
D O I：
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中图分类号：
学科分类号：
摘要：
Filgrastim is usually combined with chemotherapy to mobilize hematopoietic progenitor cells in non-Hodgkin lymphoma (NHL) patients. Limited information is available on the efficacy of a preemptive plerixafor (PLER) injection in poor mobilizers after chemotherapy and pegfilgrastim. In this prospective study, 72 patients with NHL received chemotherapy plus pegfilgrastim, and 25 hard-to-mobilize patients received also PLER. The usefulness and efficacy of our previously developed algorithm for PLER use in pegfilgrastim-containing mobilization regimen were evaluated as well as the graft cellular composition, hematological recovery, and outcome after autologous stem cell transplantation (auto-SCT) according to the PLER use. A median 3.4-fold increase in blood CD34+ cell counts was achieved after the first PLER dose. The minimum collection target was achieved in the first mobilization attempt in 66/72 patients (92%) and 68 patients (94%) proceeded to auto-SCT. An algorithm for PLER use was fulfilled in 76% of the poor mobilizers. Absolute numbers of T-lymphocytes and NK cells were significantly higher in the PLER group, whereas the number of CD34+ cells collected was significantly lower. Early neutrophil engraftment was slower in the PLER group, otherwise hematological recovery was comparable within 12 months from auto-SCT. No difference was observed in survival according to the PLER use. Chemotherapy plus pegfilgrastim combined with preemptive PLER injection is an effective and convenient approach to minimize collection failures in NHL patients intended for auto-SCT. A significant effect of PLER on the graft cellular composition was observed, but no difference in outcome after auto-SCT was detected.
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页码：1897 / 1906
页数：9
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