A study identifying the different factors influencing peripheral blood hematopoietic stem cell (PBSC) mobilization and collection in multiple myeloma (MM) and lymphoma cases determined that PBSC mobilization yielded sufficient CD34+ cell counts in both patients with MM and lymphoma, but the failure rates were high.
A study identifying the different factors influencing peripheral blood hematopoietic stem cell (PBSC) mobilization and collection in multiple myeloma (MM) and lymphoma cases determined that PBSC mobilization yielded sufficient CD34+ cell counts in both patients with MM and lymphoma, but failure rates were high.
The study, published in Oncology Letters, involved an analysis of clinical data from 128 patients, including 53 patients with MM and 75 patients with malignant lymphoma cases. Granulocyte-colony stimulating factor (G-CSF) was used in order to mobilize autologous PBSCs during chemotherapy.
“High-dose chemotherapy combined with autologous hematopoietic stem cell transplantation (ASCT) has been widely used in the treatment of hematologic malignancies, including multiple myeloma (MM) and a number of different types of lymphoma,” said the study authors. “This combination therapy has been proven to significantly improve the progression‑free survival (PFS) and overall survival (OS) times of patients. Although since 2000, a large number of targeted treatments have been used in clinical drug therapy, ASCT still results in the most favorable patient outcome.”
For patients with MM and lymphoma, the success rates of CD34+ cell acquisition were 73.6% and 58.7%, ideal rates were 43.4% and 30.7%, and failure rates were 26.4% and 41.3%, according to the study.
The univariate and multivariate analysis suggested that negative factors for PBSC mobilization in patients with MM were lenalidomide treatment, multiple chemotherapies, incomplete disease remission, and low-level blood hemoglobin.
“Further investigation is required to elucidate whether altering these factors could optimize PBSC mobilization in lymphoma, as well as in MM patients. Lymphoma and MM share the same malignant tumor cell origin and their therapeutic strategies are similar. However, in the present study the failure rate of lymphoma patient treatment was two times greater than that of MM patients,” noted the study authors.
As for patients with lymphoma, the negative factors were the histological disease type, incomplete disease remission, being beyond the first-line of previous chemotherapy, multiple chemotherapies, chemotherapy with the HyperCVAD-B mobilization scheme, high dose-MTX/Ara-c (methotrexate/cytarabine) treatment, prolonged administration of the G-CSF, and low hematocrit levels.
Despite study findings revealing that chemotherapy combined with G-CSF in patients with MM and lymphoma yielded CD34+ cells, the failure rate was relatively high, suggesting the need for further investigation of the factors associated with successful stem cell mobilization and collection to establish an efficient and cost-effective ideal protocol.
Zheng G, He J, Cai Z, et al. A retrospective study of autologous stem cell mobilization by G-CSF in combination with chemotherapy in patients with multiple myeloma and lymphoma. [published online December 3, 2019]. Oncol Lett. doi: 10.3892/ol.2019.11177.