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CD34+ cell subclasses and lymphocyte subsets in blood grafts collected after various mobilization methods in myeloma patients

Authors

  • Ville Varmavuo,

    Corresponding author
    1. From the Department of Medicine, Kuopio University Hospital, Kuopio; the Laboratory of Eastern Finland, Kuopio; the Department of Medicine, Tampere University Hospital, Tampere; and the University of Eastern Finland/Clinical Medicine, Kuopio, Finland.
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  • Pentti Mäntymaa,

    1. From the Department of Medicine, Kuopio University Hospital, Kuopio; the Laboratory of Eastern Finland, Kuopio; the Department of Medicine, Tampere University Hospital, Tampere; and the University of Eastern Finland/Clinical Medicine, Kuopio, Finland.
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  • Raija Silvennoinen,

    1. From the Department of Medicine, Kuopio University Hospital, Kuopio; the Laboratory of Eastern Finland, Kuopio; the Department of Medicine, Tampere University Hospital, Tampere; and the University of Eastern Finland/Clinical Medicine, Kuopio, Finland.
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  • Tapio Nousiainen,

    1. From the Department of Medicine, Kuopio University Hospital, Kuopio; the Laboratory of Eastern Finland, Kuopio; the Department of Medicine, Tampere University Hospital, Tampere; and the University of Eastern Finland/Clinical Medicine, Kuopio, Finland.
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  • Taru Kuittinen,

    1. From the Department of Medicine, Kuopio University Hospital, Kuopio; the Laboratory of Eastern Finland, Kuopio; the Department of Medicine, Tampere University Hospital, Tampere; and the University of Eastern Finland/Clinical Medicine, Kuopio, Finland.
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  • Esa Jantunen

    1. From the Department of Medicine, Kuopio University Hospital, Kuopio; the Laboratory of Eastern Finland, Kuopio; the Department of Medicine, Tampere University Hospital, Tampere; and the University of Eastern Finland/Clinical Medicine, Kuopio, Finland.
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Ville Varmavuo, MD, Department of Medicine, Kuopio University Hospital, PO Box 1777, 70211 Kuopio, Finland; e-mail: ville.varmavuo@kuh.fi.

Abstract

BACKGROUND: Cyclophosphamide (CY) combined with granulocyte–colony-stimulating factor (G-CSF) is commonly used to mobilize stem cells in multiple myeloma (MM). Plerixafor may also be used with G-CSF in patients who mobilize poorly or it may be added to chemomobilization to boost mobilization. Limited data are available on graft content collected after various mobilization methods.

STUDY DESIGN AND METHODS: Blood grafts collected from 21 MM patients were retrospectively analyzed. We analyzed CD34+ subclasses and lymphocyte subsets from cryopreserved grafts collected on the next morning after plerixafor injection in nine MM patients mobilized with G-CSF with (n = 5) or without preceding CY (n = 4). As controls we had the first collections from 12 MM patients mobilized with low-dose CY with G-CSF.

RESULTS: The proportion of the most primitive stem cells (CD34+CD133+CD38–) from all CD34+ cells in the graft was higher in the plerixafor-treated patients but there was no significant difference in the total number of these cells. The numbers of CD19+ B lymphocytes and natural killer cells were higher in patients collected after G-CSF plus plerixafor when compared to the patients mobilized with CY plus G-CSF. Early engraftment after high-dose melphalan was comparable between the groups.

CONCLUSION: Plerixafor appears to have effects on blood stem cell graft composition in myeloma patients. A higher number of grafts should be evaluated in regard to cellular content and longer follow-up of the patients is needed to evaluate the potential clinical impact of graft content.

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