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Using a Cyclic Ion Mobility Spectrometer for Tandem Ion Mobility Experiments
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Poor mobilizer and its countermeasures
Kanji Miyazaki1, Kenshi Suzuki1
1Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.
Summary
Preemptive plerixafor combined with G-CSF is an effective first-line strategy for hematopoietic stem cell mobilization. This approach ensures sufficient progenitor cells in most patients, avoiding the need for remobilization.
Area of Science:
- Hematology
- Transplantation Immunology
Background:
- Mobilization failure is a significant concern in hematopoietic cell transplantation, particularly in autologous settings.
- Poor mobilizers, defined by low CD34+ cell counts post-mobilization, are at high risk for harvest failure.
Purpose of the Study:
- To evaluate the efficacy of preemptive plerixafor plus G-CSF as a first-line mobilization strategy.
- To establish a treatment algorithm for optimizing peripheral blood progenitor cell (PBPC) collection and minimizing remobilization attempts.
Main Methods:
- Administering preemptive plerixafor with G-CSF (filgrastim) as the initial mobilization strategy.
- Utilizing cyclophosphamide for patients failing the first PBPC collection.
- Recommending a second mobilization attempt with plerixafor-based regimens for insufficient harvests.
Main Results:
- Preemptive plerixafor plus G-CSF yields sufficient PBPCs in nearly all patients, effectively preventing mobilization failure.
- This strategy avoids unnecessary remobilization procedures.
- Cyclophosphamide is reserved for secondary mobilization failures.
Conclusions:
- Preemptive plerixafor plus G-CSF is a highly effective first-line approach for PBPC mobilization in autologous transplantation.
- This strategy optimizes collection yields and streamlines the transplantation process.
- A clear treatment algorithm, including secondary mobilization options, is crucial for managing mobilization challenges.
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