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An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Predictive factors for stem cell mobilization failure in multiple myeloma patients: A single center experience
Hakan Goker1, Rafiye Ciftciler1, Haluk Demiroglu1
1Hacettepe University, School of Medicine, Department of Hematology, Ankara, Turkey.
Insights
Mobilization failure in multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT) is predicted by factors like male gender and prior treatments. Optimizing mobilization protocols, potentially by minimizing immunomodulatory agents, may improve stem cell yields.
Area of Science:
- Hematology
- Oncology
- Stem Cell Transplantation
Background:
- High-dose chemotherapy with autologous stem cell transplantation (ASCT) is standard for multiple myeloma (MM).
- Insufficient peripheral stem cell mobilization is a significant barrier to ASCT, limiting curative treatment opportunities.
- Identifying factors predicting mobilization failure is crucial for optimizing ASCT in MM patients.
Purpose of the Study:
- To evaluate clinical characteristics influencing stem cell mobilization failure in multiple myeloma patients.
- To identify predictors of successful or failed peripheral stem cell harvest prior to ASCT.
Main Methods:
- Retrospective analysis of 234 multiple myeloma patients undergoing stem cell mobilization.
- Data collected from Hacettepe University Hospital between 2003 and 2018.
- Univariate and multivariate analyses to identify predictors of mobilization failure.
Main Results:
- 89.3% of patients had successful initial stem cell mobilization.
- Male gender, increased chemotherapy cycles, second ASCT, and immunomodulatory treatment predicted mobilization failure (univariate analysis).
- Chemotherapy cycles, second ASCT, and immunomodulatory treatment remained independent predictors of mobilization failure (multivariate analysis).
Conclusions:
- Pre-mobilization clinical factors can predict poor stem cell harvest in MM patients.
- Individualized mobilization protocols are recommended for each patient.
- Reducing exposure to chemotherapy, particularly immunomodulatory agents, may enhance CD34+ cell collection.
Background And Aim:
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) has been considered the standard of treatment care for patients with multiple myeloma (MM). Insufficient mobilization and harvest of peripheral stem cells can be a major obstacle for performing ASCT. This is resulting in a lacking opportunity of cure in patients with MM. The aim of this study was to evaluate the factors which influence mobilization failure in patients with MM.
Materials And Methods:
This study has been performed in a retrospective manner. Two hundred and thirty-four patients with diagnosed MM who underwent stem cell mobilization after induction chemotherapy at Hacettepe University Hospital between the years of 2003 and 2018 were evaluated.
Results:
A total of 234 patients were included in this study. The median age was 54 (32-76) years at the time of diagnosis. In 209 of 234 patients (89.3%) first mobilization trial was successful. At univariate analysis, among parameters identifiable before mobilization, male gender (p = 0.03), number of chemotherapy cycle before stem cell mobilization (p < 0.001), second ASCT (p < 0.001) and immunomodulatory treatment before stem cell mobilization (p < 0.001) predicted mobilization failure. At multivariate analysis, number of chemotherapy cycle before stem cell mobilization (p = 0.03), second ASCT (p < 0.001) and immunomodulatory treatment before stem cell mobilization (p = 0.02) retained independent predictive power.
Conclusion:
Detectable different clinical characteristics of MM patients before initiating mobilization may be predictors of poor mobilization. Therefore, the mobilization protocol should be evaluated on a patient basis. Minimization of exposure to chemotheraputic agents in MM patients, especially immunomodulatory agents, may increase CD34+ cell harvest yields.
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