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Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study
SIMPLE SUMMARY: Herein, we retrospectively analyze in our single-center study real-life data of 357 myeloma and lymphoma patients mobilized with granulocyte colony-stimulating factor plus a fixed dose of Plerixafor when indicated or G-CSF alone. There were no significant differences in engraftment k...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913576/ https://www.ncbi.nlm.nih.gov/pubmed/36765566 http://dx.doi.org/10.3390/cancers15030608 |
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author | Steiner, Normann Göbel, Georg Mauser, Leonie Mühlnikel, Lena Fischinger, Marie Künz, Tina Willenbacher, Wolfgang Hetzenauer, Gabriele Rudzki, Jakob Nussbaumer, Walter Mayer, Wolfgang Gunsilius, Eberhard Kircher, Brigitte Wolf, Dominik Nachbaur, David |
author_facet | Steiner, Normann Göbel, Georg Mauser, Leonie Mühlnikel, Lena Fischinger, Marie Künz, Tina Willenbacher, Wolfgang Hetzenauer, Gabriele Rudzki, Jakob Nussbaumer, Walter Mayer, Wolfgang Gunsilius, Eberhard Kircher, Brigitte Wolf, Dominik Nachbaur, David |
author_sort | Steiner, Normann |
collection | PubMed |
description | SIMPLE SUMMARY: Herein, we retrospectively analyze in our single-center study real-life data of 357 myeloma and lymphoma patients mobilized with granulocyte colony-stimulating factor plus a fixed dose of Plerixafor when indicated or G-CSF alone. There were no significant differences in engraftment kinetics or transfusion requirements between the Plerixafor Group and the G-CSF Group in the myeloma cohort. Lymphoma patients not requiring Plerixafor showed significantly faster neutrophil recovery, a trend for faster platelet recovery, and a significantly lower need for platelet transfusions. In myeloma patients, overall survival and progression-free survival after autologous stem cell transplantation were similar between the Plerixafor Group and the G-CSF Group, with hard to mobilize lymphoma patients showing significantly poorer progression-free survival and a trend also to lower overall survival. ABSTRACT: In our single-center study, 357 myeloma and lymphoma patients between 2009 and 2019 were mobilized with granulocyte colony-stimulating factor (G-CSF 7.5 µg/kg bid for four days) plus a fixed dose of 24 mg Plerixafor when indicated (Plerixafor Group, n = 187) or G-CSF alone (G-CSF Group, n = 170). The target CD34 cell yields were ≥2.0 × 10(6) CD34+ cells/kg in lymphoma and ≥4.0 × 10(6) CD34+ cells/kg in myeloma patients to enable putative second transplants in the latter. There were no significant differences in engraftment kinetics or transfusion requirements between the Plerixafor Group and the control group in the myeloma cohort, with lymphoma patients not requiring Plerixafor showing significantly faster neutrophil recovery, a trend to faster platelet recovery, and a significantly lower need for platelet transfusions, probably due to the significantly lower number of CD34-positive cells re-transfused. While in myeloma patients the outcome (overall survival, progression-free survival) following autologous stem cell transplantation (ASCT) was similar between the Plerixafor Group and the control group, hard to mobilize lymphoma patients had significantly poorer progression-free survival (47% vs. 74% at 36 months after ASCT, p = 0.003) with a trend also to poorer overall survival (71% vs. 84%). In conclusion, while there seem to be no differences in stemness capacity and long-term engraftment efficiency between the Plerixafor and the G-CSF Group in lymphoma as well as myeloma patients, poor mobilizing lymphoma patients per se constitute a high-risk population with a poorer outcome after ASCT. Whether disease characteristics and/or a more intense or stem cell-toxic pre-mobilization chemo-/radiotherapy burden in this cohort are responsible for this observation remains to be shown in future studies. |
format | Online Article Text |
id | pubmed-9913576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99135762023-02-11 Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study Steiner, Normann Göbel, Georg Mauser, Leonie Mühlnikel, Lena Fischinger, Marie Künz, Tina Willenbacher, Wolfgang Hetzenauer, Gabriele Rudzki, Jakob Nussbaumer, Walter Mayer, Wolfgang Gunsilius, Eberhard Kircher, Brigitte Wolf, Dominik Nachbaur, David Cancers (Basel) Article SIMPLE SUMMARY: Herein, we retrospectively analyze in our single-center study real-life data of 357 myeloma and lymphoma patients mobilized with granulocyte colony-stimulating factor plus a fixed dose of Plerixafor when indicated or G-CSF alone. There were no significant differences in engraftment kinetics or transfusion requirements between the Plerixafor Group and the G-CSF Group in the myeloma cohort. Lymphoma patients not requiring Plerixafor showed significantly faster neutrophil recovery, a trend for faster platelet recovery, and a significantly lower need for platelet transfusions. In myeloma patients, overall survival and progression-free survival after autologous stem cell transplantation were similar between the Plerixafor Group and the G-CSF Group, with hard to mobilize lymphoma patients showing significantly poorer progression-free survival and a trend also to lower overall survival. ABSTRACT: In our single-center study, 357 myeloma and lymphoma patients between 2009 and 2019 were mobilized with granulocyte colony-stimulating factor (G-CSF 7.5 µg/kg bid for four days) plus a fixed dose of 24 mg Plerixafor when indicated (Plerixafor Group, n = 187) or G-CSF alone (G-CSF Group, n = 170). The target CD34 cell yields were ≥2.0 × 10(6) CD34+ cells/kg in lymphoma and ≥4.0 × 10(6) CD34+ cells/kg in myeloma patients to enable putative second transplants in the latter. There were no significant differences in engraftment kinetics or transfusion requirements between the Plerixafor Group and the control group in the myeloma cohort, with lymphoma patients not requiring Plerixafor showing significantly faster neutrophil recovery, a trend to faster platelet recovery, and a significantly lower need for platelet transfusions, probably due to the significantly lower number of CD34-positive cells re-transfused. While in myeloma patients the outcome (overall survival, progression-free survival) following autologous stem cell transplantation (ASCT) was similar between the Plerixafor Group and the control group, hard to mobilize lymphoma patients had significantly poorer progression-free survival (47% vs. 74% at 36 months after ASCT, p = 0.003) with a trend also to poorer overall survival (71% vs. 84%). In conclusion, while there seem to be no differences in stemness capacity and long-term engraftment efficiency between the Plerixafor and the G-CSF Group in lymphoma as well as myeloma patients, poor mobilizing lymphoma patients per se constitute a high-risk population with a poorer outcome after ASCT. Whether disease characteristics and/or a more intense or stem cell-toxic pre-mobilization chemo-/radiotherapy burden in this cohort are responsible for this observation remains to be shown in future studies. MDPI 2023-01-18 /pmc/articles/PMC9913576/ /pubmed/36765566 http://dx.doi.org/10.3390/cancers15030608 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Steiner, Normann Göbel, Georg Mauser, Leonie Mühlnikel, Lena Fischinger, Marie Künz, Tina Willenbacher, Wolfgang Hetzenauer, Gabriele Rudzki, Jakob Nussbaumer, Walter Mayer, Wolfgang Gunsilius, Eberhard Kircher, Brigitte Wolf, Dominik Nachbaur, David Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study |
title | Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study |
title_full | Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study |
title_fullStr | Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study |
title_full_unstemmed | Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study |
title_short | Poor Mobilizers in Lymphoma but Not Myeloma Patients Had Significantly Poorer Progression-Free Survival after Autologous Stem Cell Transplantation: Results of a Large Retrospective, Single-Center Observational Study |
title_sort | poor mobilizers in lymphoma but not myeloma patients had significantly poorer progression-free survival after autologous stem cell transplantation: results of a large retrospective, single-center observational study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913576/ https://www.ncbi.nlm.nih.gov/pubmed/36765566 http://dx.doi.org/10.3390/cancers15030608 |
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