Engraftment after autologous hematopoietic stem cell transplantation in patients mobilized with Plerixafor
M Luisa Antelo 1 , Ane Altuna 2 , J José Gimeno 3 , J Javier Ferreiro 4 , Cristina Amunárriz 5 , J José Mateos 6 , Saioa Zalba 7 , Aitziber Alkorta 8 , José Rifón 9 , J Luis Arroyo 10 , Amaia Uresandi 11 , J Antonio Moreno 12 , M Josefa Nájera 13 , Sergio Pinzón 14 , Alejandro García 15 , J Carlos Vallejo 16 , Northern Spanish Working Group for Hematopoietic stem cell mobilization and transplantation
Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored.
Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT.
The median number of PLX days to reach the stem cell collection goal (≥2 × 106 CD34+ cells/kg) was 1 (range 1-4) and the median PLX administration time before apheresis was 11 h (range 1-18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1-5) and the mean number of CD34+ cells collected was 2.95 × 106/kg (range 0-30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported.
The median time to achieve an absolute neutrophil count (ANC) >500/μL was 11 days (range 3-31) and the median time to platelet recovery >20 × 103/μL was 13 days (range 5-69). At 100 days after auto-HCT, the platelet count was 137 × 109/L (range 7-340), the ANC was 2.3 × 109/L (range 0.1-13.0), and the hemoglobin concentration was 123 g/L (range 79-165).
PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34+ cell concentration on day +4 or low CD34+ cell yield on apheresis.
CITATION Transfus Apher Sci. 2021 Apr 3;103130. doi: 10.1016/j.transci.2021.103130