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

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2013-05, Vol.53 (5), p.1024-1032
• Main Authors: Varmavuo, Ville, Mäntymaa, Pentti, Silvennoinen, Raija, Nousiainen, Tapio, Kuittinen, Taru, Jantunen, Esa
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, CD34 - blood; Biological and medical sciences; Biomarkers - blood; Blood; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cyclophosphamide - administration & dosage; Cyclophosphamide - pharmacology; Female; Flow Cytometry; Granulocyte Colony-Stimulating Factor - administration & dosage; Granulocyte Colony-Stimulating Factor - pharmacology; Hematologic Agents - administration & dosage; Hematologic Agents - pharmacology; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Mobilization - methods; Hematopoietic Stem Cell Transplantation; Hematopoietic Stem Cells - drug effects; Hematopoietic Stem Cells - metabolism; Heterocyclic Compounds - administration & dosage; Heterocyclic Compounds - pharmacology; Humans; Immune system; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunopathology; Leukapheresis; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphocyte Subsets - metabolism; Male; Medical sciences; Methods; Middle Aged; Multiple Myeloma - blood; Multiple Myeloma - therapy; Retrospective Studies; Stem cells; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Autologous; Treatment Outcome
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2012.03848.x

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.