Engraftment after autologous hematopoietic stem cell transplantation in patients mobilized with Plerixafor: a retrospective, multicenter study of a large series of patients

Resumen:
Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored. Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT. The median number of PLX days to reach the stem cell collection goal (>= 2 x 10(6) CD34(+) cells/kg) was 1 (range 1-4) and the median PLX administration time before apheresis was 11 h (range 1-18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1-5) and the mean number of CD34(+) cells collected was 2.95 x 10(6)/kg (range 0-30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported. The median time to achieve an absolute neutrophil count (ANC) >500/mu L was 11 days (range 3-31) and the median time to platelet recovery >20 x 10(3)/mu L was 13 days (range 5-69). At 100 days after auto-HCT, the platelet count was 137 x 10(9)/L (range 7-340), the ANC was 2.3 x 10(9)/L (range 0.1-13.0), and the hemoglobin concentration was 123 g/L (range 79-165). PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34(+) cell concentration on day +4 or low CD34(+) cell yield on apheresis.