An approach to autologous stem cell mobilization: trying to define good mobilizers.

Sara Montolio Chiva, Paula Gomez Fernandez, Antonio Manuel Gutiérrez Garcia, Maria Del Carmen Ballester Ruiz, Antonia Sampol Mayol, Albert Perez Montaña
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Abstract

Background and objectives: Stem cell mobilization is a well-known procedure to harvest hematopoietic stem cells for autologous stem cell transplantation in certain hematologic diseases. Numerous studies have been conducted to identify risk factors for poor mobilization but there are no studies that identify good mobilizers. In our hospital, we decided to explore good mobilizers, defining them as those with ≥40 CD34+ cells/μL on Day +4 in order to start early apheresis.

Material and methods: A descriptive retrospective study was performed at Hospital Universitari Son Espases. A total of 198 patients mobilized with doses of around 10 µg/kg of granulocyte colony-stimulating factor (G-CSF) every 12 h were analyzed for autologous collection between January 2015 and September 2022. Fifty patients who had ≥40 CD34+ cells/μL on Day +4 started early apheresis; the rest continued mobilization as planned. Success was defined as obtaining over 2.5 × 106 CD34+ cells/kg in a single apheresis.

Results: The necessary number of CD34+ cells/kg to perform an autologous stem cell transplantation was reached in a single apheresis session in 62 % of patients with ≥40 CD34+ cells/μL in peripheral blood. A cutoff of 102 CD34+ cells/μL on Day +4 was shown to have the best success rate (94 %). In an analysis of success, age, previously failed mobilization and having one or more adverse factors for bad mobilization were statistically significant.

Conclusion: Patients considered as good mobilizers were matched with our factors of poor mobilization, revealing that most patients (79 %) had none or only one risk factor for poor mobilization. Apheresis on Day +4 in good mobilizers was shown to be an effective alternative to reduce mobilization duration and decrease the amount of granulocyte-colony stimulating factor administered.

自体干细胞动员方法:尝试定义好的动员者。
背景和目的:干细胞动员是一种众所周知的采集造血干细胞的程序,用于某些血液病的自体干细胞移植。已有大量研究确定了动员不良的风险因素,但尚无研究确定动员良好者。在我们医院,我们决定探索动员良好者,将其定义为在第+4天CD34+细胞数≥40个/μL的动员良好者,以便尽早开始无细胞采集:材料和方法:Son Espases大学医院进行了一项描述性回顾研究。在2015年1月至2022年9月期间,共对198名每12小时使用约10微克/千克粒细胞集落刺激因子(G-CSF)动员的患者进行了自体采集分析。第+4天CD34+细胞数≥40个/μL的50名患者开始了早期无细胞采集;其余患者按计划继续动员。单次血液净化获得超过2.5×106个CD34+细胞/千克即为成功:结果:在外周血中CD34+细胞≥40个/μL的患者中,62%的患者在单次无细胞抽吸中达到了进行自体干细胞移植所需的CD34+细胞/kg数量。第+4天CD34+细胞/μL为102的临界值成功率最高(94%)。在对成功率的分析中,年龄、之前的动员失败以及有一个或多个不利于不良动员的因素都具有统计学意义:我们将被视为动员良好的患者与动员不良的因素进行了比对,发现大多数患者(79%)没有或只有一个动员不良的危险因素。对于动员良好的患者,在第+4天进行血液净化可有效缩短动员时间,减少粒细胞集落刺激因子的用量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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