Autologous hematopoietic SCT (auto-HSCT) provides hematopoietic support after high-dose
chemotherapy and is the standard of care for patients with
multiple myeloma (MM) or chemosensitive relapsed high- or intermediate-grade
non-Hodgkin's lymphoma (NHL). However, yields of hematopoietic stem cells vary greatly between patients, and the optimal strategy to mobilize hematopoietic stem cells into peripheral blood for collection has not been defined. Current mobilization strategies consist of
cytokines alone or in combination with chemotherapeutic agents.
Cytokine-only mobilization regimens are well tolerated, but their utility is limited by suboptimal PBSC yields. When a myelosuppressive chemotherapeutic agent is added to a
cytokine mobilization regimen, PBSC collections improve two- to five-fold. This benefit is tempered by increased toxicity, morbidity and resource utilization. All current regimens fail to mobilize sufficient hematopoietic stem cells to proceed to
transplantation in 5-30% of patients, necessitating additional mobilization attempts or precluding
transplantation, which may negatively affect patient outcomes and survival. Improved strategies to mobilize stem cells would increase the availability of auto-HSCT and optimize engraftment and outcomes in patients with MM or NHL. Novel agents used in conjunction with
cytokines have the potential to increase PBSC collections without introducing additional morbidity, thereby improving patient outcomes.