Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score

J. Olivieri, I. Attolico, R. Nuccorini, S.P. Pascale, M. Chiarucci, M. Poiani, P. Corradini, L. Farina, G. Gaidano, L. Nassi, S. Sica, N. Piccirillo, P.E. Pioltelli, M. Martino, T. Moscato, M. Pini, F. Zallio, F. Ciceri, S. Marktel, A. MengarelliP. Musto, S. Capria, F. Merli, K. Codeluppi, G. Mele, F. Lanza, G. Specchia, D. Pastore, G. Milone, F. Saraceni, E. Di Nardo, P. Perseghin, A. Olivieri

Research output: Contribution to journalArticle

Abstract

Predicting mobilization failure before it starts may enable patient-tailored strategies. Although consensus criteria for predicted PM (pPM) are available, their predictive performance has never been measured on real data. We retrospectively collected and analyzed 1318 mobilization procedures performed for MM and lymphoma patients in the plerixafor era. In our sample, 180/1318 (13.7%) were PM. The score resulting from published pPM criteria had sufficient performance for predicting PM, as measured by AUC (0.67, 95%CI: 0.63-0.72). We developed a new prediction model from multivariate analysis whose score (pPM-score) resulted in better AUC (0.80, 95%CI: 0.76-0.84, p <0001). pPM-score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before mobilization, previous mobilization failure, priming strategy with G-CSF alone, or without upfront plerixafor. A simplified version of pPM-score was categorized using a cut-off to maximize positive likelihood ratio (15.7, 95%CI: 9.9-24.8); specificity was 98% (95%CI: 97-98.7%), sensitivity 31.7% (95%CI: 24.9-39%); positive predictive value in our sample was 71.3% (95%CI: 60-80.8%). Simplified pPM-score can "rule in" patients at very high risk for PM before starting mobilization, allowing changes in clinical management, such as choice of alternative priming strategies, to avoid highly likely mobilization failure. © 2017 The Author(s) 2017, under exclusive licence to Macmillan Publishers Limited, part of Springer Nature.
Original languageEnglish
Pages (from-to)461-473
Number of pages13
JournalBone Marrow Transplantation
Volume53
Issue number4
DOIs
Publication statusPublished - 2018

Fingerprint

Hematopoietic Stem Cell Mobilization
Area Under Curve
Granulocyte Colony-Stimulating Factor
Licensure
Lymphoma
Multivariate Analysis
Bone Marrow
Biopsy
JM 3100

Keywords

  • carmustine
  • cyclophosphamide
  • cytarabine
  • filgrastim
  • fludarabine
  • granulocyte colony stimulating factor
  • lenalidomide
  • lenograstim
  • melphalan
  • pegfilgrastim
  • plerixafor, adult
  • age
  • area under the curve
  • Article
  • bone marrow biopsy
  • cancer radiotherapy
  • cytopenia
  • diagnostic test accuracy study
  • female
  • Hodgkin disease
  • human
  • lymphoma
  • major clinical study
  • male
  • medical decision making
  • middle aged
  • multiple cycle treatment
  • multiple myeloma
  • nonhodgkin lymphoma
  • observational study
  • prediction
  • predictive value
  • priority journal
  • receiver operating characteristic
  • remission
  • retrospective study
  • risk assessment
  • scoring system
  • sensitivity and specificity
  • stem cell mobilization
  • treatment failure

Cite this

Olivieri, J., Attolico, I., Nuccorini, R., Pascale, S. P., Chiarucci, M., Poiani, M., ... Olivieri, A. (2018). Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score. Bone Marrow Transplantation, 53(4), 461-473. https://doi.org/10.1038/s41409-017-0051-y

Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score. / Olivieri, J.; Attolico, I.; Nuccorini, R.; Pascale, S.P.; Chiarucci, M.; Poiani, M.; Corradini, P.; Farina, L.; Gaidano, G.; Nassi, L.; Sica, S.; Piccirillo, N.; Pioltelli, P.E.; Martino, M.; Moscato, T.; Pini, M.; Zallio, F.; Ciceri, F.; Marktel, S.; Mengarelli, A.; Musto, P.; Capria, S.; Merli, F.; Codeluppi, K.; Mele, G.; Lanza, F.; Specchia, G.; Pastore, D.; Milone, G.; Saraceni, F.; Di Nardo, E.; Perseghin, P.; Olivieri, A.

In: Bone Marrow Transplantation, Vol. 53, No. 4, 2018, p. 461-473.

Research output: Contribution to journalArticle

Olivieri, J, Attolico, I, Nuccorini, R, Pascale, SP, Chiarucci, M, Poiani, M, Corradini, P, Farina, L, Gaidano, G, Nassi, L, Sica, S, Piccirillo, N, Pioltelli, PE, Martino, M, Moscato, T, Pini, M, Zallio, F, Ciceri, F, Marktel, S, Mengarelli, A, Musto, P, Capria, S, Merli, F, Codeluppi, K, Mele, G, Lanza, F, Specchia, G, Pastore, D, Milone, G, Saraceni, F, Di Nardo, E, Perseghin, P & Olivieri, A 2018, 'Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score', Bone Marrow Transplantation, vol. 53, no. 4, pp. 461-473. https://doi.org/10.1038/s41409-017-0051-y
Olivieri, J. ; Attolico, I. ; Nuccorini, R. ; Pascale, S.P. ; Chiarucci, M. ; Poiani, M. ; Corradini, P. ; Farina, L. ; Gaidano, G. ; Nassi, L. ; Sica, S. ; Piccirillo, N. ; Pioltelli, P.E. ; Martino, M. ; Moscato, T. ; Pini, M. ; Zallio, F. ; Ciceri, F. ; Marktel, S. ; Mengarelli, A. ; Musto, P. ; Capria, S. ; Merli, F. ; Codeluppi, K. ; Mele, G. ; Lanza, F. ; Specchia, G. ; Pastore, D. ; Milone, G. ; Saraceni, F. ; Di Nardo, E. ; Perseghin, P. ; Olivieri, A. / Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score. In: Bone Marrow Transplantation. 2018 ; Vol. 53, No. 4. pp. 461-473.
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T1 - Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score

AU - Olivieri, J.

AU - Attolico, I.

AU - Nuccorini, R.

AU - Pascale, S.P.

AU - Chiarucci, M.

AU - Poiani, M.

AU - Corradini, P.

AU - Farina, L.

AU - Gaidano, G.

AU - Nassi, L.

AU - Sica, S.

AU - Piccirillo, N.

AU - Pioltelli, P.E.

AU - Martino, M.

AU - Moscato, T.

AU - Pini, M.

AU - Zallio, F.

AU - Ciceri, F.

AU - Marktel, S.

AU - Mengarelli, A.

AU - Musto, P.

AU - Capria, S.

AU - Merli, F.

AU - Codeluppi, K.

AU - Mele, G.

AU - Lanza, F.

AU - Specchia, G.

AU - Pastore, D.

AU - Milone, G.

AU - Saraceni, F.

AU - Di Nardo, E.

AU - Perseghin, P.

AU - Olivieri, A.

N1 - cited By 1

PY - 2018

Y1 - 2018

N2 - Predicting mobilization failure before it starts may enable patient-tailored strategies. Although consensus criteria for predicted PM (pPM) are available, their predictive performance has never been measured on real data. We retrospectively collected and analyzed 1318 mobilization procedures performed for MM and lymphoma patients in the plerixafor era. In our sample, 180/1318 (13.7%) were PM. The score resulting from published pPM criteria had sufficient performance for predicting PM, as measured by AUC (0.67, 95%CI: 0.63-0.72). We developed a new prediction model from multivariate analysis whose score (pPM-score) resulted in better AUC (0.80, 95%CI: 0.76-0.84, p <0001). pPM-score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before mobilization, previous mobilization failure, priming strategy with G-CSF alone, or without upfront plerixafor. A simplified version of pPM-score was categorized using a cut-off to maximize positive likelihood ratio (15.7, 95%CI: 9.9-24.8); specificity was 98% (95%CI: 97-98.7%), sensitivity 31.7% (95%CI: 24.9-39%); positive predictive value in our sample was 71.3% (95%CI: 60-80.8%). Simplified pPM-score can "rule in" patients at very high risk for PM before starting mobilization, allowing changes in clinical management, such as choice of alternative priming strategies, to avoid highly likely mobilization failure. © 2017 The Author(s) 2017, under exclusive licence to Macmillan Publishers Limited, part of Springer Nature.

AB - Predicting mobilization failure before it starts may enable patient-tailored strategies. Although consensus criteria for predicted PM (pPM) are available, their predictive performance has never been measured on real data. We retrospectively collected and analyzed 1318 mobilization procedures performed for MM and lymphoma patients in the plerixafor era. In our sample, 180/1318 (13.7%) were PM. The score resulting from published pPM criteria had sufficient performance for predicting PM, as measured by AUC (0.67, 95%CI: 0.63-0.72). We developed a new prediction model from multivariate analysis whose score (pPM-score) resulted in better AUC (0.80, 95%CI: 0.76-0.84, p <0001). pPM-score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before mobilization, previous mobilization failure, priming strategy with G-CSF alone, or without upfront plerixafor. A simplified version of pPM-score was categorized using a cut-off to maximize positive likelihood ratio (15.7, 95%CI: 9.9-24.8); specificity was 98% (95%CI: 97-98.7%), sensitivity 31.7% (95%CI: 24.9-39%); positive predictive value in our sample was 71.3% (95%CI: 60-80.8%). Simplified pPM-score can "rule in" patients at very high risk for PM before starting mobilization, allowing changes in clinical management, such as choice of alternative priming strategies, to avoid highly likely mobilization failure. © 2017 The Author(s) 2017, under exclusive licence to Macmillan Publishers Limited, part of Springer Nature.

KW - carmustine

KW - cyclophosphamide

KW - cytarabine

KW - filgrastim

KW - fludarabine

KW - granulocyte colony stimulating factor

KW - lenalidomide

KW - lenograstim

KW - melphalan

KW - pegfilgrastim

KW - plerixafor, adult

KW - age

KW - area under the curve

KW - Article

KW - bone marrow biopsy

KW - cancer radiotherapy

KW - cytopenia

KW - diagnostic test accuracy study

KW - female

KW - Hodgkin disease

KW - human

KW - lymphoma

KW - major clinical study

KW - male

KW - medical decision making

KW - middle aged

KW - multiple cycle treatment

KW - multiple myeloma

KW - nonhodgkin lymphoma

KW - observational study

KW - prediction

KW - predictive value

KW - priority journal

KW - receiver operating characteristic

KW - remission

KW - retrospective study

KW - risk assessment

KW - scoring system

KW - sensitivity and specificity

KW - stem cell mobilization

KW - treatment failure

U2 - 10.1038/s41409-017-0051-y

DO - 10.1038/s41409-017-0051-y

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VL - 53

SP - 461

EP - 473

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

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