Similar dynamics of intraapheresis autologous CD34+ recruitment and collection efficiency in patients undergoing mobilization with or without plerixafor

Authors

  • Henning Schade,

    1. Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
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  • Saurabh Chhabra,

    1. Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
    2. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Yubin Kang,

    1. Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
    2. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Robert K. Stuart,

    1. Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
    2. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Kathy H. Edwards,

    1. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Cindy Kramer,

    1. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Coleen Butcher,

    1. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Amanda Littleton,

    1. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Molly Schneider,

    1. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
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  • Milos N. Budisavljevic,

    1. Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
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  • Luciano J. Costa

    Corresponding author
    1. Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
    2. Blood and Marrow Transplantation Program, Medical University of South Carolina, Charleston, South Carolina
    • Address reprint requests to: Luciano J. Costa, MD, PhD, Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, 903 CSB MSC 635, Charleston, SC 29425-6350; e-mail: costalj@musc.edu.

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  • The content of this manuscript was presented at the American Society of Hematology Annual Meeting New Orleans, LA, December 7-10, 2013.

Abstract

Background

Compared with growth factor (G) alone, the combination of G with plerixafor (G + P) increases peripheral blood CD34+ count (PB-CD34+) and improves CD34+ collection yield (yCD34+) in multiple myeloma and lymphoma patients undergoing autologous hematopoietic progenitor cell (AHPC) mobilization. It is unknown whether the improved yCD34+ with G + P results entirely from expansion of PB-CD34+ or also from increased intraapheresis CD34+ recruitment and collection efficiency.

Study Design and Methods

We retrospectively studied 192 patients who underwent AHPC mobilization and collection with G (n = 73) or G + P (n = 119) to compare the adjusted relative efficiency (aRE), the proportion of the circulating CD34+ pool that is captured for each blood volume processed. Additionally, in a prospective cohort of nine patients mobilizing with G and 11 with G + P, PB-CD34+ after leukapheresis allowed calculation of the recruitment coefficient (RC), proportion of the initial CD34+ pool recruited from the marrow into peripheral blood for each blood volume processed.

Results

There was no difference in aRE between G and G + P (0.50 vs. 0.46; p = 0.37) and no substantial decline in aRE with higher blood volumes processed in either group. RC was also not different between G and G + P (median, 0.39 and 0.38, respectively; p = 0.7). Prediction of yCD34+ was determined essentially by PB-CD34+ and not affected independently by plerixafor.

Conclusion

Kinetics of intraapheresis CD34+ recruitment and collection is proportional to PB-CD34+ but not influenced further by plerixafor.

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