TY - JOUR
T1 - The timing of plerixafor addition to G-Csf and chemotherapy affects immunological recovery after autologous stem cell transplant in multiple myeloma
AU - Tolomelli, Giulia
AU - Mancuso, Katia
AU - Tacchetti, Paola
AU - Patriarca, Francesca
AU - Galli, Monica
AU - Pantani, Lucia
AU - Zannetti, Beatrice
AU - Motta, Maria Rosa
AU - Rizzi, Simonetta
AU - Dan, Elisa
AU - Sinigaglia, Barbara
AU - Giudice, Valeria
AU - Olmo, Andrea
AU - Arpinati, Mario
AU - Chirumbolo, Gabriella
AU - Fanin, Renato
AU - Lewis, Russell E.
AU - Paris, Laura
AU - Bonifazi, Francesca
AU - Cavo, Michele
AU - Curti, Antonio
AU - Lemoli, Roberto M.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Plerixafor inhibits CXCR4, thus inducing the mobilization of hematopoietic stem/progenitor cells in lymphoma and multiple myeloma (MM) patients eligible for autologous stem cell transplantation (ASCT). However, the kinetics of plerixafor-induced mobilization of lymphocyte subsets is poorly known. Here, we evaluated the graft content, the engraftment, and the immunological reconstitution of MM patients receiving plerixafor. Thirty-seven patients undergoing one or tandem ASCT were enrolled. After mobilization with cyclophosphamide plus G-CSF, plerixafor was added at hematological recovery regardless of CD34+ cell count. We evaluated the number of CD34+, CD34+/CD38−, CD3+, CD4+, CD8+, CD19+, CD56+/CD3−, CD4+/CD25+/FOXP3+, and CD138+/CD38+ cells on each apheresis. Hematological and immunological recovery were determined at 30 days, 3, 6, 9, and 12 months after ASCT. Overall, 34/37 patients mobilized a median of 10.1 × 106 CD34+ cells/Kg (IQ 7.7–13.4). Patients with <20/µL CD34+ cells at plerixafor administration (18/33) had a significantly higher CD34+ cell fold increase, but not a higher absolute number, than 16/33 patients with ≥20/µL CD34+ cells. A similar CD34+ and immune graft composition was reported. A higher number of CD3+ and CD8+ cells/µL was observed at 3 months after first ASCT (p < 0.05) in the group with ≥20 CD34+ cells/µL. Thus, in MM patients, the timing of plerixafor administration influences immunological recovery.
AB - Plerixafor inhibits CXCR4, thus inducing the mobilization of hematopoietic stem/progenitor cells in lymphoma and multiple myeloma (MM) patients eligible for autologous stem cell transplantation (ASCT). However, the kinetics of plerixafor-induced mobilization of lymphocyte subsets is poorly known. Here, we evaluated the graft content, the engraftment, and the immunological reconstitution of MM patients receiving plerixafor. Thirty-seven patients undergoing one or tandem ASCT were enrolled. After mobilization with cyclophosphamide plus G-CSF, plerixafor was added at hematological recovery regardless of CD34+ cell count. We evaluated the number of CD34+, CD34+/CD38−, CD3+, CD4+, CD8+, CD19+, CD56+/CD3−, CD4+/CD25+/FOXP3+, and CD138+/CD38+ cells on each apheresis. Hematological and immunological recovery were determined at 30 days, 3, 6, 9, and 12 months after ASCT. Overall, 34/37 patients mobilized a median of 10.1 × 106 CD34+ cells/Kg (IQ 7.7–13.4). Patients with <20/µL CD34+ cells at plerixafor administration (18/33) had a significantly higher CD34+ cell fold increase, but not a higher absolute number, than 16/33 patients with ≥20/µL CD34+ cells. A similar CD34+ and immune graft composition was reported. A higher number of CD3+ and CD8+ cells/µL was observed at 3 months after first ASCT (p < 0.05) in the group with ≥20 CD34+ cells/µL. Thus, in MM patients, the timing of plerixafor administration influences immunological recovery.
UR - http://www.scopus.com/inward/record.url?scp=85075422010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075422010&partnerID=8YFLogxK
U2 - 10.1038/s41409-019-0756-1
DO - 10.1038/s41409-019-0756-1
M3 - Article
AN - SCOPUS:85075422010
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
ER -