Mobilization Strategies in Myeloma Patients Intended for Autologous Hematopoietic Cell Transplantation

Background: Multiple myeloma is currently the leading indication for autologous hematopoietic cell transplantation (AHCT). A prerequisite for AHCT is mobilization and collection of adequate blood graft to support high-dose therapy. Current mobilization strategies include granulocyte colony-stimulating factor (G-CSF) alone or in combination with chemotherapy most commonly cyclophosphamide (CY). More recently, plerixafor has become into agenda especially in patients who mobilize poorly. In the selection of a mobilization method, several factors should be considered. Summary: Preplanned collection target is important as G-CSF plus plerixafor is more effective in the mobilization of CD34+ cells than G-CSF alone. On the other hand, CY plus G-CSF is superior to G-CSF only mobilization. Previous therapy and age of the patients are important considerations as G-CSF alone may not be effective enough in patients with risk factors for poor mobilization. These factors include extensive lenalidomide exposure, irradiation to bone marrow-bearing sites, higher age, or a previous mobilization failure. Also, local preferences and experiences as well as the number of apheresis needed are important issues as well as cost-effectiveness considerations. Mobilization method used may have implication for cellular composition of collected grafts, which might have an impact on posttransplant events such as hematologic and immune recovery in addition to also potential long-term outcomes. Key Message: Currently, G-CSF alone and preemptive plerixafor if needed might be considered as a standard mobilization strategy in MM patients intended for AHCT.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Mobilization Strategies in Myeloma Patients Intended for Autologous Hematopoietic Cell Transplantation ; volume:50 ; number:5 ; year:2023 ; pages:438-447 ; extent:10
Transfusion medicine and hemotherapy ; 50, Heft 5 (2023), 438-447 (gesamt 10)

Urheber
Jantunen, Esa
Partanen, Anu
Turunen, Antti
Varmavuo, Ville
Silvennoinen, Raija

DOI
10.1159/000531940
URN
urn:nbn:de:101:1-2023101900323436643083
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
14.08.2025, 10:55 MESZ

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Beteiligte

  • Jantunen, Esa
  • Partanen, Anu
  • Turunen, Antti
  • Varmavuo, Ville
  • Silvennoinen, Raija

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