Journal article
Plerixafor and abbreviated-course granulocyte colony-stimulating factor for mobilizing hematopoietic progenitor cells in light chain amyloidosis
Biology of blood and marrow transplantation, Vol.20(12), pp.1926-1931
12/2014
DOI: 10.1016/j.bbmt.2014.08.002
PMID: 25111581
Abstract
Cytokine-based mobilization in light chain (AL) amyloidosis is frequently complicated by fluid overload, weight gain, cardiac arrhythmias, and peri-mobilization mortality. We analyzed hematopoietic progenitor cells (HPC) mobilization outcomes in 49 consecutive AL amyloidosis patients at our institution between 2004 and 2013 with granulocyte colony-stimulating factor (G) (10 μg/kg/day) (n = 25) versus an institutional protocol to limit G exposure using plerixafor (P) (.24 mg/kg s.c. starting day 3 of G 10 μg/kg) (n = 24). G+P strategy yielded higher total CD34(+) cells/kg (12.8 × 10(6) versus 6.3 × 10(6); P < .001) and CD34(+) cells/kg collected on day 1 (10.8 × 10(6) versus 4.9 × 10(6), P = .004) compared with the G cohort. More G+P patients collected ≥5 × 10(6) CD34(+) HPCs/kg (22 versus 16, P = .02) and ≥ 10 × 10(6) CD34(+) HPCs/kg (13 versus 5, P = .01). Four patients (16%) had mobilization failure with G; none with G+P. Peri-mobilization weight gain was lower with G+P strategy (median weight gain 1 versus 7 pounds, P = .009). Numbers of apheresis sessions (median, 1 versus 1, P = .52), number of hospitalization days (median, 1.1 versus 1.6, P = .52), transfusions, use of intravenous antibiotics, and cardiac arrhythmias were similar. In conclusion, our study demonstrates that upfront use of G+P as a mobilization strategy results in superior HPC collection, no mobilization failures, and less weight gain than G alone.
Details
- Title: Subtitle
- Plerixafor and abbreviated-course granulocyte colony-stimulating factor for mobilizing hematopoietic progenitor cells in light chain amyloidosis
- Creators
- Binod Dhakal - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinChristopher Strouse - Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WisconsinAnita D'Souza - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinCarlos Arce-Lara - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinJeanie Esselman - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinDaniel Eastwood - Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WisconsinMarcelo Pasquini - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinWael Saber - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinWilliam Drobyski - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinJ Douglas Rizzo - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinParameswaran N Hari - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WisconsinMehdi Hamadani - Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: mhamadani@mcw.edu
- Resource Type
- Journal article
- Publication Details
- Biology of blood and marrow transplantation, Vol.20(12), pp.1926-1931
- DOI
- 10.1016/j.bbmt.2014.08.002
- PMID
- 25111581
- NLM abbreviation
- Biol Blood Marrow Transplant
- ISSN
- 1083-8791
- eISSN
- 1523-6536
- Language
- English
- Date published
- 12/2014
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984094359702771
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