Faculty Collaboration Database

Salvage bone marrow harvest in patients failing plerixafor-based stem cell mobilization attempt: feasibility and autologous transplantation outcomes. Biol Blood Marrow Transplant 2013 Jul;19(7):1133-5

Date

05/03/2013

Pubmed ID

23635452

DOI

10.1016/j.bbmt.2013.04.019

Scopus ID

2-s2.0-84879370980 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Inadequate mobilization of peripheral blood progenitor cells (PBPC) is sometimes a limiting factor to proceed with an autologous hematopoietic cell transplantation (auto-HCT), in an otherwise eligible patient. In such situations, a bone marrow harvest (BMH) procedure may be considered to achieve the CD34+ target dose for an autograft. Plerixafor-based mobilization has recently been shown to improve PBPC collection yields. However, the feasibility and outcomes of BMH in patients failing plerixafor-based mobilization is not known. We report here, 6 patients who underwent BMH after PBPC mobilization failure with plerixafor. The median CD34+ yield with plerixafor mobilization and BMH were 1.15 x 10^6/Kg (range, 0.2-1.7 × 10^6/Kg) and 0.32 (range, 0.12-0.38 × 10^6/Kg), respectively. Three patients proceeded to an auto-HCT, with only 1 patient receiving CD34+ cell dose of at least 2 × 10^6/Kg. While neutrophil recovery was seen, platelet recovery and red cell transfusion independence were delayed. All 3 autografted patients experienced disease progression by day +100. These data suggest, limited incremental benefit of a salvage BMH after plerixafor mobilization failure, cautioning against routine use of this strategy.

Author List

Kanate AS, Watkins K, Cumpston A, Craig M, Hamadani M

Author

Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Antigens, CD34
Benzylamines
Blood Platelets
Bone Marrow Cells
Disease Progression
Female
Hematologic Neoplasms
Hematopoietic Stem Cell Mobilization
Heterocyclic Compounds
Humans
Male
Middle Aged
Peripheral Blood Stem Cell Transplantation
Transplantation, Autologous
Treatment Failure