Blood stem cell mobilization and collection in patients with lymphoproliferative diseases: practical issues

More than 15,000 autologous stem cell transplants (ASCT) were reported to European Blood and Bone Marrow Transplantation registry in 2005, most commonly for multiple myeloma (MM) and lymphomas. In 98% of the cases high-dose therapy was supported by blood stem cells. Thus stem cell mobilization and collection are integral parts of ASCT protocols. We give here a practical approach to blood stem cell mobilization and collection in patients with various lymphoproliferative diseases. While mobilization is usually easy and straightforward in patients with MM, about 10-20% of patients with non-Hodgkin's lymphoma or Hodgkin's lymphoma are hard-to-mobilize. There seems to be even more disease-specific issues in blood stem cell mobilization in patients with chronic lymphocytic leukaemia and in patients with light chain amyloidosis. We also discuss options in hard-to-mobilize patients.