The timing of plerixafor addition to G-Csf and chemotherapy affects immunological recovery after autologous stem cell transplant in multiple myeloma

Giulia Tolomelli, Katia Mancuso, Paola Tacchetti, Francesca Patriarca, Monica Galli, Lucia Pantani, Beatrice Zannetti, Maria Rosa Motta, Simonetta Rizzi, Elisa Dan, Barbara Sinigaglia, Valeria Giudice, Andrea Olmo, Mario Arpinati, Gabriella Chirumbolo, Renato Fanin, Russell E. Lewis, Laura Paris, Francesca Bonifazi, Michele CavoAntonio Curti, Roberto M. Lemoli

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
JournalBone Marrow Transplantation
DOIs
Publication statusAccepted/In press - Jan 1 2019

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint

Dive into the research topics of 'The timing of plerixafor addition to G-Csf and chemotherapy affects immunological recovery after autologous stem cell transplant in multiple myeloma'. Together they form a unique fingerprint.

Cite this