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Agreements and uncertainties in autologous haematopoietic stem cell mobilization and collection. A Spanish consensus document

Abstract

Although many experts position statements on autologous stem cell mobilization have been published, there are some aspects that are still under discussion. A Spanish Hematologist expert group was summoned to settle on agreements and uncertainties on PBSCs mobilization, including factors not always considered; as apheresis and cytometry key factors that determine a successful PBSC collection. This document reviews critical factors that define poor mobilizer patients and the tools to better collect the desired stem cells for a successful autologous haematopoietic stem cell transplant.

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References

  1. Pusic I, Jiang SY, Landua S, Uy GL, Rettig MP, Cashen AF et al. Impact of mobilization and remobilization strategies on achieving sufficient stem cell yields for autologous transplantation. Biol Blood Marrow Transpl. 2008. https://doi.org/10.1016/j.bbmt.2008.07.004.

  2. Wuchter P, Ran D, Bruckner T, Schmitt T, Witzens-Harig M, Neben K, et al. Poor mobilization of hematopoietic stem cells-definitions, incidence, risk factors, and impact on outcome of autologous transplantation. Biol Blood Marrow Transpl. 2010;16:490–9.

    Article  CAS  Google Scholar 

  3. Giralt S, Stadtmauer EA, Harousseau JL, Palumbo A, Bensinger W, Comenzo RL, et al. International myeloma working group (IMWG) consensus statement and guidelines regarding the current status of stem cell collection and high-dose therapy for multiple myeloma and the role of plerixafor (AMD 3100). Leukemia. 2009. https://doi.org/10.1038/leu.2009.127.

    Article  PubMed  Google Scholar 

  4. Douglas KW, Gilleece M, Hayden P, Hunter H, Peter |, Johnson RE et al. UK consensus statement on the use of plerixafor to facilitate autologous peripheral blood stem cell collection to support high- dose chemoradiotherapy for patients with malignancy. J Clin Apher 2018;33:46–59.

  5. Olivieri A, Marchetti M, Lemoli R, Tarella C, Iacone A, Lanza F et al. Proposed definition of ‘poor mobilizer’ in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo ItalianoTrapianto di Midollo Osseo on behalf of the Italian Group for Stem Cell Transplantation (GITMO). Bone Marrow Transpl. 2012;47:342–51. https://doi.org/10.1038/bmt.2011.82.

  6. Duong HK, Savani BN, Copelan E, Devine S, Costa LJ, Wingard JR et al. Peripheral blood progenitor cell mobilization for autologous and allogeneic hematopoietic cell transplantation: guidelines from the american society for blood and marrow transplantation. Biol. Blood Marrow Transplant. 2014. https://doi.org/10.1016/j.bbmt.2014.05.003.

  7. Sancho JM, Duarte R, Medina L, Querol S, Marín P, Sureda A Movilización de progenitores hematopoyéticos a sangre periférica con plerixafor en pacientes malos movilizadores. Med Clin (Barc). 2016. https://doi.org/10.1016/j.medcli.2016.05.019.

  8. Mohty M. Autologous haematopoietic stem cell mobilisation in multiple myeloma and lymphoma patients: a position statement from the European group for blood and marrow transplantation. Bone Marrow Transpl. 2014;49:865–72.

    Article  CAS  Google Scholar 

  9. Sureda A, Bader P, Cesaro S, Dreger P, Duarte RF, Dufour C et al. Indications for allo- and auto-SCT for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2015. Bone Marrow Transpl. 2015. https://doi.org/10.1038/bmt.2015.6.

  10. Passweg JR, Baldomero H, Bader P, Bonini C, Duarte RF, Dufour C et al. Use of haploidentical stem cell transplantation continues to increase: the 2015 european society for blood and marrow transplant activity survey report. Bone Marrow Transpl. 2017. https://doi.org/10.1038/bmt.2017.34.

  11. Mohty M, Azar N, Chabannon C, Le Gouill S, Karlin L, Farina L et al. Plerixafor in poor mobilizers with non-Hodgkin’s lymphoma: a multi-center time-motion analysis. Bone Marrow Transpl. 2018. https://doi.org/10.1038/s41409-017-0033-0.

  12. Alegre A, Tomás JF, Martínez-Chamorro C, Gil-Fernández JJ, Fernández-Villalta MJ, Arranz R et al. Comparison of peripheral blood progenitor cell mobilization in patients with multiple myeloma: high-dose cyclophosphamide plus GM-CSF vs G-CSF alone. Bone Marrow Transpl. 1997. https://doi.org/10.1038/sj.bmt.1700867.

  13. Moreb JS, Byrne M, Shugarman I, Zou F, Xiong S, May WS et al. Poor peripheral blood stem cell mobilization affects long-term outcomes in multiple myeloma patients undergoing autologous stem cell transplantation. https://doi.org/10.1002/jca.21556.

  14. To LB, Levesque JP, Herbert KE. How I treat patients who mobilize hematopoietic stem cells poorly. Blood. 2011. https://doi.org/10.1182/blood-2011-06-318220.

  15. Sánchez-Ortega I, Querol S, Encuentra M, Ortega S, Serra A, Sanchez-Villegas JM et al. Plerixafor in patients with lymphoma and multiple myeloma: Effectiveness in cases with very low circulating CD34+ cell levels and preemptive intervention vs remobilization. Bone Marrow Transpl. 2015. https://doi.org/10.1038/bmt.2014.196.

  16. Worel N, Frank N, Frech C, Fritsch G. Influence of plerixafor on the mobilization of CD34+ cell subpopulations and lymphocyte subtypes. Transfusion. 2017;57:2206–15.

    Article  CAS  Google Scholar 

  17. Teipel R, Oelschlägel U, Wetzko K, Schmiedgen M, Kramer M, Rücker-Braun E, et al. Differences in cellular composition of peripheral blood stem cell grafts from healthy stem cell donors mobilized with either granulocyte colony-stimulating factor (G-CSF) alone or G-CSF and plerixafor. Biol Blood Marrow Transpl. 2018;24:2171–7.

    Article  CAS  Google Scholar 

  18. Prentice AM, Jebb SA. Beyond body mass index. Obes Rev. 2001. https://doi.org/10.1046/j.1467-789x.2001.00031.x.

  19. Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery. 1962;51:224–32.

  20. Alegre A, Diaz MA, Madero L, Granda A, de la Vega A, Villa M et al. Large-volume leukapheresis for peripheral blood stem cell collection in children: a simplified single-apheresis approach. Bone Marrow Transpl. 1996;17:923–7.

  21. Passos-Coelho JL, Braine HG, Wright SK, Davis JM, Schepers KG, Huelskamp AM et al. Large-volume leukapheresis using regional citrate anticoagulation to collect peripheral blood progenitor cells. J Hematother. 1995;4:11–9.

  22. Bojanic I, Dubravcic K, Batinic D, Cepulic BG, Mazic S, Hren D et al. Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times. Transfus Apher Sci. 2011. https://doi.org/10.1016/j.transci.2011.01.005.

  23. Cid J, Carbassé G, Alba C, Perea D, Lozano M. Leukocytapheresis in nonmobilized donors for cellular therapy protocols: Evaluation of factors affecting collection efficiency of cells. J Clin Apher. 2019. https://doi.org/10.1002/jca.21745. [Epub ahead of print].

  24. Cid J, Carbassé G, Cid-Caballero M, López-Púa Y, Alba C, Perea D et al. The Barcelona Hospital Clínic therapeutic apheresis database. J Clin Apher. 2018. https://doi.org/10.1002/jca.21587.

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Acknowledgements

The authors wish to thank Sanofi Genzyme for logistical support in the organization of author meetings to work on this national consensus. This consensus document has the endorsement of the Spanish Society and Hematology and Hemotherapy (SEHH), the Spanish Group for Hematopoietic Transplantation and Cellular Therapy (GETH) and the Spanish Society of Blood Transfusion (SETS).

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Correspondence to J. L. Bueno.

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JLB, CA, RFD, FFF, JMGG; SQ, IVM, CV; CA, RG have consulted for Sanofi Genzyme and received honoraria. AA has also been a Member of Advisory Boards for Celgene, Janssen, Amgen, Takeda and received research Funding from Celgene, Janssen and Amgem. MC declare Speaker honoraria from Amgem and Support for CME from Sanofi Genzyme. MLA has been a member of Advisory Boards and has received support for CME from Sanofi, Terumo-BCT and Novartis, and has received speaker honoraria and research funding from Novartis. Dr. Blanquer do not declare conflict of interest.

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Bueno, J.L., Alegre, A., López-Villar, O. et al. Agreements and uncertainties in autologous haematopoietic stem cell mobilization and collection. A Spanish consensus document. Bone Marrow Transplant 55, 811–817 (2020). https://doi.org/10.1038/s41409-019-0716-9

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