Stem Cell Mobilization Efficiency and Engraftment Kinetics in Patients with Hematologic Malignancies Undergoing Autologous Stem Cell Transplantation: A Retrospective Cohort StudyNuri Barış Hasbal, Mutlu Arat
Objective: This study aimed to conduct a retrospective evaluation of clinical findings on patients undergoing autologous hematopoietic stem cell transplantation.
Materials and Methods: A total of 167 consecutive patients who were diagnosed with multiple myeloma (MM) and lymphoma and then underwent autologous hematopoietic stem cell transplantation (AHSCT) between August 2010 and May 2013 were included in our study. Demographic, disease, mobilization, apheresis, and transplantation data were reviewed from patient files.
Results: In 121 patients (72%), mobilization was achieved solely with granulocyte colony stimulating factor (G-CSF). There was no relationship between peripheral CD34+ cell count and age, disease type, or previous treatment features. The total CD34+ cell count postapheresis was 3.3 ± 3.1 × 106 /kg. Only nine patients could not achieve successful mobilization with any regimen. The median day of neutrophil and platelet engraftment among the entire patient group was 11 days. As the number of CD34+ cells infused into patients increased, neutrophil and platelet engraftment time decreased.
Conclusion: Mobilization was achieved in most MM cases and at least two-thirds of lymphomas using G-CSF alone. Age and body weight did not affect mobilization success. Clinicians should increase successful mobilizations on the first day of the apheresis and prescribe AHSCT at appropriate times to avoid excessive cycles of chemotherapy.