The role of stem cell mobilization regimen on lymphocyte collection yield in patients with multiple myeloma.

Abstract

BACKGROUND:

The lymphocyte dose (LY-DO) infused during an autograft influences absolute lymphocyte (ALC) recovery and survival following autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients. Factors influencing lymphocyte yield (LY-C) during leukapheresis have been poorly studied.

METHODS:

Factors that could influence survival, LY-C and CD34(+) cell yield were analyzed in 122 MM patients. Three mobilization regimens were used, granulocyte-colony-stimulating factor (G-CSF) alone (n=13), cyclophosphamide 1-2 g/m(2) plus G-CSF (LD-CY, n=62) and cyclophosphamide 3-4 g/m(2) and G-CSF (ID-CY, n=47).

RESULTS:

Using multivariate analysis, age, LY-C, ALC on day 30 (ALC-30) and International Staging System stage significantly influenced overall (OS) and progression-free survival (PFS) following ASCT. PFS (56 versus 29 months, P=0.05) and OS (72 versus 49 months; P=0.07) were longer in the LY-C>or=0.12x10(9)/kg group than the LY-C<0.12x10(9)/kg group. LY-C also influenced ALC on day 15 (ALC-15). Mobilization regimen, lymphocytes on the day of leukapheresis, prior radiotherapy and number of leukaphereses significantly influenced LY-C. Significantly higher LY-C was obtained with G-CSF alone compared with the LD-CY and ID-CY groups. CD34(+) count on the day of leukapheresis, prior chemotherapy with prednisone, cyclophosphamide, adriamycin and BCNU or melphalan, and stem cell mobilization regimen significantly influenced CD34(+) cell yield.

DISCUSSION:

LY-C influenced ALC-15 and survival following ASCT. Factors that influenced CD34(+) cell yield and LY-C during leukapheresis were different. Mobilization should be tailored to maximize the LY-C and CD34(+) cell yield.

• Authors: D K Hiwase, S Hiwase, M Bailey, G Bollard, A P Schwarer
• Journal: Cytotherapy (Cytotherapy) Vol. 10 Issue 5 Pg. 507-17 ( 2008) ISSN: 1477-2566 [Electronic] England
• PMID: 18608354 (Publication Type: Journal Article)

Chemical References

• Antigens, CD34
• Granulocyte Colony-Stimulating Factor
• Cyclophosphamide

Topics

• Adult
• Aged
• Antigens, CD34 (biosynthesis, genetics, immunology)
• Cell Survival (immunology)
• Cyclophosphamide (administration & dosage)
• Dose-Response Relationship, Drug
• Female
• Granulocyte Colony-Stimulating Factor (administration & dosage)
• Hematopoietic Stem Cell Mobilization
• Humans
• Lymphocyte Depletion
• Male
• Middle Aged
• Multiple Myeloma (mortality, pathology, therapy)
• Neoplasm Staging
• Recovery of Function
• Stem Cell Transplantation
• Survival Analysis
• Transplantation, Autologous