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Kriegsmann K, Bittrich M, Sauer S, Tietze-Stolley C, Movassaghi K, Grube M, Vucinic V, Wehler D, Burchert A, Schmidt-Hieber M, Rank A, Dürk HA, Metzner B, Kimmich C, Hentrich M, Kunz C, Hartmann F, Khandanpour C, de Wit M, Holtick U, Kiehl M, Stoltefuß A, Kiani A, Naumann R, Scholz CW, Tischler HJ, Görner M, Brand F, Ehmer M, Kröger N. Mobilization and Hematopoietic Stem Cell Collection in Poor Mobilizing Patients with Lymphoma: Final Results of the German OPTIMOB Study. Transfus Med Hemother 2023; 50:403-416. [PMID: 37899991 PMCID: PMC10601601 DOI: 10.1159/000531936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/03/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Successful mobilization and collection of peripheral hematopoietic stem cells (HSCs) are necessary for lymphoma patients eligible for myeloablative chemotherapy with subsequent autologous stem cell transplantation (ASCT). Albeit G-CSF alone or combined with chemotherapy is well-established methods for HSC mobilization, up to 40% of the patients fail to mobilize (poor mobilizer, PM). Plerixafor (PLX) is commonly used in PM patients resulting in increased migration of HSCs into peripheral blood and thus improves the collection outcome. Methods The prospective, multicenter, open-label, non-interventional OPTIMOB study assessed mobilization and collection parameter of patients with lymphoma or multiple myeloma to get deep insights in the treatment of those patients in clinical routine focusing on PM patients. PM was defined as follows: (1) no achievement of ≥20 CD34+ progenitor cells/µL before first apheresis, (2) PLX administration at any time point during the observational period, (3) reduction of the initially planned CD34+ progenitor cell yield as necessity due to failed mobilization or HSC collection, and (4) no performance of apheresis due to low CD34+ progenitor level. Primary objective of the study was to assess mobilization success by the proportion of PM patients achieving >2 × 106 CD34+ progenitor cells/kg body weight on the first day of apheresis. Here, the data of the lymphoma cohort are presented. Results Out of 238 patients with lymphoma documented in the study, 32% were classified as PM. 87% of them received PLX. Demographic data revealed no obvious differences between PM and good mobilizing (GM) patients. All patients were treated highly individualized prior to mobilization. Majority of all PM patients were able to undergo apheresis (95%) and reached their individual requested CD34+ progenitor cell target (72%). 57% of the PM patients achieved >2.0 × 106 CD34+ progenitor cells/kg body weight on day 1 of apheresis and nearby 70% of them underwent ASCT. Median time to engraftment was similar in PM and GM patients of the lymphoma cohort. Conclusions Majority of PM patients with lymphoma were successfully mobilized and underwent ASCT. Most of them received PLX during the study.
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Affiliation(s)
- Katharina Kriegsmann
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
- Laborarztpraxis, Laborarztpraxis Rhein-Main MVZ GbR, Limbach Gruppe SE, Frankfurt, Germany
| | - Max Bittrich
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Sandra Sauer
- Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carola Tietze-Stolley
- Department of Hematology and Oncology, Stem Cell Facility, University Hospital Charité, Berlin, Germany
| | - Kamran Movassaghi
- Department of Hematology and Oncology, Stem Cell Facility, University Hospital Charité, Berlin, Germany
| | - Matthias Grube
- Department of Hematology and Internistic Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Vladan Vucinic
- Klinik und Poliklinik für Hämatologie, Zelltherapie und Hämostaseologie, University Hospital Leipzig, Leipzig, Germany
| | - Daniela Wehler
- Klinik und Poliklinik für Innere Medizin III, University Hospital of Mainz, Mainz, Germany
| | - Andreas Burchert
- Klinik für Hämatologie, Onkologie und Immunologie, University Hospital of Gießen and Marburg (UKGM), Marburg, Germany
| | - Martin Schmidt-Hieber
- 2. Medizinische Klinik für Hämatologie, Onkologie, Pneumologie und Nephrologie, Carl-Thiem Hospital Cottbus gGmbH, Cottbus, Germany
| | - Andreas Rank
- 2. Medizinische Klinik – Hämatologie, Internistische Onkologie und Hämostaseologie, University Hospital of Augsburg, Augsburg, Germany
| | - Heinz A. Dürk
- Klinik für Hämatologie und Onkologie, St. Barbara Hospital Hamm-Heessen, Hamm, Germany
| | - Bernd Metzner
- Universitätsklinik für Innere Medizin – Onkologie und Hämatologie, University Hospital Klinikum Oldenburg, Oldenburg, Germany
| | - Christoph Kimmich
- Universitätsklinik für Innere Medizin – Onkologie und Hämatologie, University Hospital Klinikum Oldenburg, Oldenburg, Germany
| | - Marcus Hentrich
- Abteilung für Innere Medizin III –Hämatologie und Onkologie, Rotkreuzklinikum München, Munich, Germany
| | - Christian Kunz
- Innere Medizin I, Westpfalz-Klinikum Kaiserslautern, Kaiserslautern, Germany
| | - Frank Hartmann
- Klinik für Onkologie und Hämatologie, Hospital Lippe-Lemgo, Lemgo, Germany
| | - Cyrus Khandanpour
- Medizinische Klinik A, University Hospital Münster, Münster, Germany
- Klinik für Hämatologie und Onkologie, University Hospital Schleswig-Holstein (Campus Lübeck) and University of Lübeck, Lübeck, Germany
| | - Maike de Wit
- Klinik für Innere Medizin – Hämatologie, Onkologie und Palliativmedizin, Vivantes Hospital Neukölln, Berlin, Germany
| | - Udo Holtick
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Michael Kiehl
- Medizinische Klinik I, Hospital Frankfurt (Oder), Frankfurt/Oder, Germany
| | - Andrea Stoltefuß
- Klinik für Innere Medizin II, Evangelisches Krankenhaus Hamm, Hamm, Germany
| | - Alexander Kiani
- Department of Hematology and Oncology, Klinikum Bayreuth, Bayreuth, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Ralph Naumann
- Klinik für Hämatologie, Medizinische Onkologie und Palliativmedizin, St. Marien-Krankenhaus Marien Gesellschaft Siegen gGmbH, Siegen, Germany
| | - Christian W. Scholz
- Klinik für Innere Medizin – Hämatologie und Onkologie, Vivantes Hospital Am Urban, Berlin, Germany
| | - Hans-Joachim Tischler
- Universitätsklinik für Hämatologie, Onkologie, Hämostaseologie und Palliativmedizin, Johannes Wesling Hospital Minden, Mühlenkreiskliniken, Minden, Germany
| | - Martin Görner
- Klinik für Hämatologie, Onkologie, Palliativmedizin und Stammzelltherapie, Hospital Bielefeld-Mitte, Bielefeld, Germany
| | | | - Martin Ehmer
- Sanofi-Aventis Deutschland GmbH, Berlin, Germany
| | - Nicolaus Kröger
- Interdisziplinäre Klinik und Poliklinik für Stammzelltransplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Shi Y, Zhou P, Han X, He X, Zhou S, Liu P, Yang J, Zhang C, Gui L, Qin Y, Yang S, Zhao L, Yao J, Zhang S. Autologous peripheral blood stem cell mobilization following dose-adjusted cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy alone or in combination with rituximab in treating high-risk non-Hodgkin's lymphoma. CHINESE JOURNAL OF CANCER 2015; 34:522-30. [PMID: 26370464 PMCID: PMC4593367 DOI: 10.1186/s40880-015-0045-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 07/26/2015] [Indexed: 01/27/2023]
Abstract
Background The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is an efficient treatment of non-Hodgkin’s lymphoma (NHL). This study aimed to assess the efficacy and toxicity of dose-adjusted CHOP alone or in combination with rituximab (R-CHOP) by examining the stem cell mobilization in NHL patients. Factors affecting the collection of CD34+ cells were also explored. Methods Our retrospective study included 39 patients eligible for autologous stem cell transplantation: 14 patients who expressed CD20 and were financially eligible received R-CHOP for autologous peripheral blood stem cell (APBSC) mobilization; the remaining 25 patients received CHOP. Results The median CD34+ cell yield was 7.01 × 106 cells/kg body weight (range 1.49–28.39 × 106 cells/kg body weight), with only two patients failing to meet the target CD34+ cell harvest of ≥2.0 × 106 cells/kg body weight. The median number of apheresis procedures per patient was 1 (range 1–3). The APBSC mobilization yield of the CHOP group appeared to be higher than that of the R-CHOP group (P = 0.005), whereas the success rate was similar between groups. R-CHOP elevated the complete response (CR) rate in B cell lymphoma patients as compared with CHOP (P = 0.01). No significant differences in toxicity or engraftment were observed between the two groups. Conclusion The present study demonstrated that dose-adjusted CHOP chemotherapy effectively mobilized APBSCs in NHL patients and that the addition of rituximab to dose-adjusted CHOP chemotherapy elevated the CR rate for patients with B-cell lymphoma.
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Affiliation(s)
- Yuankai Shi
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Ping Zhou
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Xiaohong Han
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Xiaohui He
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Shengyu Zhou
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Peng Liu
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Jianliang Yang
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Changgong Zhang
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Lin Gui
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Yan Qin
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Sheng Yang
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Liya Zhao
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Jiarui Yao
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
| | - Shuxiang Zhang
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, 100021, P. R. China.
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