Blood graft cellular composition and posttransplant recovery in non-Hodgkin's lymphoma patients mobilized with or without plerixafor: a prospective comparison.

Abstract

BACKGROUND:

Autologous stem cell transplantation is commonly used to treat non-Hodgkin's lymphomas (NHLs). Cellular composition of the blood grafts apparently has a role in the posttransplant hematologic and immune recovery. Plerixafor increases the mobilization of CD34+ cells and higher amounts of various lymphocyte subsets have been reported in the grafts. Limited prospective data are available in regard to graft cellular composition, hematologic and immune recovery, and patient outcomes in NHL patients who receive plerixafor added to chemomobilization.

STUDY DESIGN AND METHODS:

Forty-one patients with NHL participated in this prospective study. All patients received chemomobilization and 15 poor mobilizers also received plerixafor. CD34+ cell subsets and lymphocyte subsets of cell grafts, posttransplant hematologic and immune recovery, and outcome were evaluated.

RESULTS:

Blood grafts in the plerixafor group contained a significantly higher proportion of CD34+133+CD38- cells and more lymphocytes of all major subsets except B lymphocytes. Neutrophil engraftment was comparable and platelet recovery slightly slower in the plerixafor group. Natural killer cell recovery was significantly faster in patients mobilized with plerixafor. Otherwise hematologic and immune recovery as well as short-time outcome were comparable even though there was a trend for progression-free survival and overall survival benefit in the plerixafor group.

CONCLUSIONS:

In poorly mobilizing NHL patients, plerixafor added to chemomobilization is safe and effective. It also modifies the blood graft composition in many ways, some of which have been linked to better outcomes in previous studies. Larger sets of patients and longer follow-up are needed to see whether plerixafor-mobilized grafts are associated with superior outcome of the patients.

• Authors: Jaakko Valtola, Ville Varmavuo, Antti Ropponen, Anne Nihtinen, Anu Partanen, Kaija Vasala, Päivi Lehtonen, Karri Penttilä, Marja Pyörälä, Taru Kuittinen, Raija Silvennoinen, Tapio Nousiainen, Jukka Pelkonen, Pentti Mäntymaa, Esa Jantunen
• Journal: Transfusion (Transfusion) Vol. 55 Issue 10 Pg. 2358-68 (Oct 2015) ISSN: 1537-2995 [Electronic] United States
• PMID: 26018461 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 AABB.

Chemical References

• Anti-HIV Agents
• Benzylamines
• Cyclams
• Heterocyclic Compounds
• plerixafor

Topics

• Adult
• Aged
• Anti-HIV Agents (administration & dosage)
• Autografts
• Benzylamines
• Cyclams
• Disease-Free Survival
• Female
• Graft Survival
• Hematopoietic Stem Cell Mobilization (methods)
• Heterocyclic Compounds (administration & dosage, adverse effects)
• Humans
• Leukocytes (metabolism)
• Lymphoma, Non-Hodgkin (blood, mortality, therapy)
• Male
• Peripheral Blood Stem Cell Transplantation
• Prospective Studies
• Survival Rate