Autologous peripheral blood stem cell mobilization and collection in patients with lymphoma and multiple myeloma. A single-center experience using the plerixa for pre-emptive approach

Abstract

Objectives: To review and assess the efficiency of pre-emptive plerixafor administration for poor mobilization (PM) and to review and assess mobilization efficiency (≥2×106 CD34+ cells/kg) in patients who received autologous stem cell transplantation for lymphoma and multiple myeloma (MM) at the Department of Adult Hematology/Blood Marrow Transplant, Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia, over the past 7 years. Methods: This retrospective study evaluated all patients with MM and lymphoma undergoing peripheral blood stem cell mobilization and collection at our institution between February 2014 and August 2021. Plerixafor was administered pre-emptively by a plateau of <10 peripheral blood CD34+/μl after chemotherapy-based mobilization or CD34+ of <8/μL on day 4 after mobilization with G-CSF alone. Between peak CD34+ levels of 10-15/μl, plerixafor will be used at the discretion of the treating physician. Results: In total, 215 patients were enrolled. Among them, 80% had peak CD34+ level ≥20/μL, 11% had clear poor mobilization (peak CD34+ levels <10/μL), and 9% had borderline PM (CD34+ between 10-19/μL). Plerixafor was administered pre-emptively in 13% of the patients and 75% of patients with borderline PM were collected without plerixafor, suggesting that plerixafor is not needed if CD34+ >15/μL on the anticipated collection day. Mobilization failed in only one patient (<1%). Conclusion: Our data showed that with plerixafor pre-emptive administration, the primary endpoint was achieved for most patients identified with PM, preventing the need for a second mobilization attempt.