Mobilization and Hematopoietic Stem Cell Collection in Poor Mobilizing Patients with Lymphoma: Final Results of the German OPTIMOB Study.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-09-21 eCollection Date: 2023-10-01 DOI:10.1159/000531936

Katharina Kriegsmann, Max Bittrich, Sandra Sauer, Carola Tietze-Stolley, Kamran Movassaghi, Matthias Grube, Vladan Vucinic, Daniela Wehler, Andreas Burchert, Martin Schmidt-Hieber, Andreas Rank, Heinz A Dürk, Bernd Metzner, Christoph Kimmich, Marcus Hentrich, Christian Kunz, Frank Hartmann, Cyrus Khandanpour, Maike de Wit, Udo Holtick, Michael Kiehl, Andrea Stoltefuß, Alexander Kiani, Ralph Naumann, Christian W Scholz, Hans-Joachim Tischler, Martin Görner, Franziska Brand, Martin Ehmer, Nicolaus Kröger

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引用次数: 1

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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淋巴瘤动员能力差患者的动员和造血干细胞收集：德国OPTIMOB研究的最终结果。

引言：成功动员和收集外周造血干细胞（HSC）对于符合清髓化疗条件的淋巴瘤患者以及随后的自体干细胞移植（ASCT）是必要的。尽管单独使用G-CSF或联合化疗是公认的HSC动员方法，但高达40%的患者无法动员（动员不良，PM）。Plerixafor（PLX）通常用于PM患者，导致HSC向外周血的迁移增加，从而改善采集结果。方法：前瞻性、多中心、开放标签、非介入性OPTIMOB研究评估了淋巴瘤或多发性骨髓瘤患者的动员和收集参数，以深入了解以PM患者为重点的临床常规治疗中这些患者的情况。PM的定义如下：（1）第一次单采前未实现≥20个CD34+祖细胞/µL，（2）在观察期内的任何时间点给予PLX，（3）由于动员或HSC收集失败，最初计划的CD34+祖细胞产量减少，这是必要的；（4）由于CD34+祖体水平低，单采无效果。本研究的主要目的是通过PM患者在单采第一天达到>2×106CD34+祖细胞/kg体重的比例来评估动员成功率。这里，淋巴瘤队列的数据。结果：在研究中记录的238例淋巴瘤患者中，32%被归类为PM。其中87%接受了PLX。人口统计学数据显示，PM和良好动员（GM）患者之间没有明显差异。所有患者在动员前都进行了高度个性化的治疗。大多数PM患者能够进行单采（95%），并达到其个人要求的CD34+祖细胞靶点（72%）。57%的PM患者在单采第1天达到>2.0×106CD34+祖细胞/kg体重，其中约70%的患者接受了ASCT。淋巴瘤队列中PM和GM患者的中位植入时间相似。结论：大多数淋巴瘤PM患者均成功动员并接受ASCT。他们中的大多数人在研究期间接受了PLX。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.

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