Literatür Detay Bilgisi
Plerixafor + G-CSF vs. Placebo + G-CSF for Mobilization of CD34+ Hematopoietic Stem Cells in Patients with Multiple Myeloma Who Have Low Peripheral Blood CD34+ Cell Count: Results of a Subset Analysis of a Randomized Trial.
Yazarlar : Nademanee AP, Dipersio JF, Maziarz RT, et al
Yayın : Biol Blood Marrow Transplant.
Yayın Yılı : 2012
Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22683613
Konu : Aferez
Literatür İçeriği :
Abstract
Pre-apheresis peripheral blood CD34(+) cell count is a strong predictor of hematopoietic stem cell mobilization and is routinely used to optimize the timing, cost, and success of hematopoietic stem cell collection in patients with multiple myeloma. However, a uniform peripheral blood CD34(+) cell count that predicts mobilization failure has not been defined resulting in institute-specific algorithms for mobilization, particularly with the decision of when to use the novel stem cell mobilization agent plerixafor. In this post-hoc analysis we evaluate the mobilization efficacy of plerixafor plus granulocyte-colony stimulating factor (G-CSF) vs. placebo plus G-CSF in patients with multiple myeloma, stratified by pre-apheresis peripheral blood CD34(+) cell count: <10, <15, <20, and ≥20 cells/μL. Regardless of the peripheral blood CD34(+) cell count, the total yield of CD34+ cells from apheresis was significantly higher in the plerixafor group than in the placebo group, and significantly more patients who received plerixafor, collected minimum (≥2 × 10(6) cells/kg) and optimum (≥6 × 10(6) cells/kg) stem cell yields on each apheresis day. As a corollary, the higher stem cell collection in plerixafor-treated patients resulted in the need for significantly fewer days of apheresis to reach minimum and optimum cell doses, across all cell count groups. For all CD34(+) cell count groups, the proportion of patients proceeding to transplant, and the median time to platelet and neutrophil engraftment were similar between plerixafor and placebo patients. Our findings demonstrate that in patients with multiple myeloma who might be predicted to fail mobilization based on low peripheral blood CD34(+) cell count, the addition of plerixafor to G-CSF allows for collection of the minimal and optimal cell dose in a greater proportion of patients, compared with G-CSF alone. Additionally, plerixafor plus G-CSF significantly improves the likelihood of optimal hematopoietic stem cell collection for patients who have higher pre-apheresis peripheral blood CD34(+) cell counts (≥20 cells/μL) compared with placebo plus G-CSF. Collectively, this analysis in predicted poor mobilizers validates the superiority of plerixafor plus G-CSF compared to G-CSF alone, which was demonstrated previously in the overall patient populationKonusu Aynı Olan Diğer Materyaller
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