Blood graft composition and post-transplant recovery in myeloma patients mobilized with plerixafor: a prospective multicenter study

Abstract

The composition of autologous blood grafts after cryopreservation, post-transplant hematological recovery up to 1 year and immune recovery up to 6 months as well as outcome was analyzed in 87 patients with multiple myeloma (MM). The patients receiving added plerixafor due to poor mobilization (11%) were compared to those mobilized with G-CSF or cyclophosphamide (CY) plus G-CSF. The use of plerixafor was found to significantly affect the graft composition as there was a significantly higher proportion of the more primitive CD34⁺ cells, higher number of T and B lymphocytes as well as NK cells in the grafts of patients who received also plerixafor. The hematological recovery after auto-SCT was comparable between the groups. The recovery of CD3⁺CD4⁺ T cells was faster in plerixafor mobilized patients at 1 and 3 months post-transplant. There were no significant differences in progression-free (PFS) or overall survival (OS) according to the plerixafor use.

Keywords:

• Multiple myeloma
• autologous stem cell transplantation
• plerixafor
• graft composition
• hematological recovery
• immune recovery
• outcome

Acknowledgments

The help of research nurses Kirsi Kvist-Mäkelä, Helena Järviö, and Eeva Kiljander is acknowledged. Dr. Valtola is grateful for the scholarships granted by the Research Foundation of Hematological Diseases, the Cancer Fund of North Savo District, Paavo Koistinen Fund, the Finnish Cultural Foundation, The Finnish-Norwegian Medical Foundation, The Finnish Medical Society Duodecim and the Kuopio University Hospital Research Foundation.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1485911.