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Brief CommunicationBrief Communication
Open Access

Autologous peripheral blood stem cell mobilization and collection in patients with lymphoma and multiple myeloma

A single-center experience using the plerixa for pre-emptive approach

Ahmad S. Alsaeed, Mona J. Najib, Sameer M. Al Amoudi, Ihab Y. Elhemaidi, Ahmed A. Absi, Majed D. Al Ahmadi, Saleem K. Eldadah, Walaa A. Rajkhan, Manar M. Khalil and Mohammed H. Almohammadi
Saudi Medical Journal June 2022, 43 (6) 626-632; DOI: https://doi.org/10.15537/smj.2022.43.6.20210912
Ahmad S. Alsaeed
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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  • For correspondence: [email protected]
Mona J. Najib
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Sameer M. Al Amoudi
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Ihab Y. Elhemaidi
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Ahmed A. Absi
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Majed D. Al Ahmadi
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Saleem K. Eldadah
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Walaa A. Rajkhan
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Manar M. Khalil
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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Mohammed H. Almohammadi
From the Oncology Department (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil), Princess Noorah Oncology Center; from the Department of Pathology and Laboratory Medicine (Najib, Almohammadi), King Abdulaziz Medical City, Ministry of the National Guard Health Affairs; from the Research Unit (Alsaeed, Najib, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Eldadah, Rajkhan, Khalil, Almohammadi), King Abdullah International Medical Research Center; from the Department of Medicine (Alsaeed, Al Amoudi, Elhemaidi, Absi, Al Ahmadi, Almohammadi), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, and from the Saudi Society for Blood and Marrow Transplantation (Alsaeed), Riyadh Kingdom of Saudi Arabia.
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    Figure 1

    - peripheral blood stem cell mobilization and collection (± preemtive plerixafor).

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    Table 1

    - Patient characteristics.

    ParametersOverallHLNHLMM
    Patients number215 (100)86 (40.0)63 (29.3)66 (30.7)
    Gender#x00A0;#x00A0;#x00A0;#x00A0;
    Male144 (67.0)57 (66.3)43 (68.3)44 (66.7)
    Female71 (33.0)29 (33.7)20 (31.7)22 (33.3)
    Age (years) at PBSC collection, median (range)40 (14-69)27 (14-55)42 (16-62)53 (27-69)
    Body weight (kg) at PBSC collection, median (range)71 (31-149)67 (31-149)74 (40-124)72 (52-131)
    Specification diagnosis, n#x00A0;#x00A0;DLBCL= 38MM= 63
    ALCL= 8POEMS= 3
    TCL= 5
    BL= 4
    MCL= 3
    FL= 2
    Others= 3

    Data are presented as number and precentage (%). MM: multiple myeloma, PBSC: peripheral blood stem cell, DLBCL: diffuse large B-cell lymphoma, ALCL: anaplastic large cell lymphoma, TCL: T-cell lymphoma, BL: Burkitt’s lymphoma, MCL: mantle cell lymphoma, FL: follicular lymphoma, HL: Hodgkin’s lymphoma, NHL: non-Hodgkin’s lymphoma, POEMS: polyneuropathy organomegaly endocrinopathy monoclonal protein skin changes

      • View popup
      Table 2

      - Parameters and results of peripheral blood stem cells mobilization and collection.

      ParametersOverallHLNHLMM
      Patients number215 (100)86 (40)63 (29.3)66 (30.7)
      Blood count pre-collection LP1, median (range)
      WBC × 109/L15 (3.1-97)21 (3.4-81.9)13.1 (3.1-97)12.3 (4.1-73.8)
      MNC%21.1 (3.7-88)16.8 (4.7-31.6)26.7 (3.7-74.7)18.8 (5.1-88)
      Mobilization regimens
      Cyclophosphamide61 (28.4)1 (1.2)1 (1.6)59 (89.4)
      ESHAP/R-ESHAP64 (29.8)30 (34.9)34 (54.0)-
      IGEV/R-IGEV7 (3.3)5 (5.8)2 (3.2)-
      GDP6 (2.8)5 (5.8)1 (1.6)-
      R-ICE4 (1.9)-4 (6.3)-
      DHAP/R-DHAP2 (0.9)-2 (3.2)-
      CHOP/R-CHOP1 (0.4)-1 (1.6)-
      Cytrabine + Etoposide5 (2.3)-5 (7.9)-
      Other chemo-mobilizations3 (1.4)1 (1.2)1 (1.6)1 (1.5)
      G-CSF only62 (28.8)44 (51.1)12 (19.0)6 (9.1)
      Plerixafor administration
      Yes29 (13.5)13 (15.1)9 (14.3)7 (10.6)
      No186 (86.5)73 (84.9)54 (85.7)59 (89.4)
      PBSC collection,
      PB CD34+ cells/µL at maximum stimulation, median (range)61 (0-1367)48 (1-735)56 (0-1367)76 (3-304)
      PB CD34+ cells/µL at day 1 of LP, median (range)63 (9-1367)60 (11-735)62 (10-1367)79 (9-304)
      Peak CD34+ cells (<10/µL) in PB24 (11.2)11 (12.8)9 (14.3)4 (6.1)
      Peak CD34+ cells (10-<20/µL) in PB20 (9.3)8 (9.3)7 (11.1)5 (7.6)
      Peak CD34+ cells (≥20/µL) in PB171 (79.5)67 (77.9)47 (74.6)57 (86.3)
      Patients with 2 LP sessions37 (17.2)14 (16.3)11 (17.5)12 (18.2)
      CD34+ cells collection ×106/kg (BW), median (range)5.1 (2.03-66.2)4.5 (2.19-66.2)4.6 (2.03-30.7)6.6 (2.77-18.75)
      Overall processed TBV, mean±SD2.2 (0.62)1.9 (0.49)2.2 (0.65)2.2 (0.62)
      Failed first pre-emptive dosing of plerixafor5 (2.3)3 (3.5)2 (3.2)0 (0.0)
      Failure of PBSC mobilization1 (0.5)0 (0.0)1 (1.6)0 (0.0)

      Data are presented as number and percentage (%). HL: Hodgkin’s lymphoma, NHL: non-Hodgkin’s lymphoma, MM: multiple myeloma, LP1: leukapheresis-1, WBC: white blood cell, MNC: mononuclear blood cells, R-ESHAP: rituximab, etoposide, methylprednisolone, cytarabine, and cisplatin, R- IGEV: rituximab, ifosfamide, gemcitabine, and vinorelbine, GDP: gemcitabine, dexamethasone, and cisplatin, R-ICE: rituximab, etoposide, ifosfamide, and carboplatin, R-DHAP: rituximab, dexamethasone, cisplatin, and cytarabine, R-CHOP: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, G-CSF: granulocyte colony-stimulating factor, PBSC: peripheral blood stem cell, PB: peripheral blood, LP: leukapheresis, BW: body weight, TBV: total blood volume

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      Autologous peripheral blood stem cell mobilization and collection in patients with lymphoma and multiple myeloma
      Ahmad S. Alsaeed, Mona J. Najib, Sameer M. Al Amoudi, Ihab Y. Elhemaidi, Ahmed A. Absi, Majed D. Al Ahmadi, Saleem K. Eldadah, Walaa A. Rajkhan, Manar M. Khalil, Mohammed H. Almohammadi
      Saudi Medical Journal Jun 2022, 43 (6) 626-632; DOI: 10.15537/smj.2022.43.6.20210912

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      Autologous peripheral blood stem cell mobilization and collection in patients with lymphoma and multiple myeloma
      Ahmad S. Alsaeed, Mona J. Najib, Sameer M. Al Amoudi, Ihab Y. Elhemaidi, Ahmed A. Absi, Majed D. Al Ahmadi, Saleem K. Eldadah, Walaa A. Rajkhan, Manar M. Khalil, Mohammed H. Almohammadi
      Saudi Medical Journal Jun 2022, 43 (6) 626-632; DOI: 10.15537/smj.2022.43.6.20210912
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      Keywords

      • autologous stem cell transplant
      • poor mobilization
      • lymphoma
      • multiple myeloma
      • plerixafor

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