Plerixafor inhibits CXCR4, thus inducing the mobilization of hematopoietic stem/progenitor cells in lymphoma and multiple myeloma (MM) patients eligible for autologous stem cell transplantation (ASCT). However, the kinetics of plerixafor-induced mobilization of lymphocyte subsets is poorly known. Here, we evaluated the graft content, the engraftment, and the immunological reconstitution of MM patients receiving plerixafor. Thirty-seven patients undergoing one or tandem ASCT were enrolled. After mobilization with cyclophosphamide plus G-CSF, plerixafor was added at hematological recovery regardless of CD34(+) cell count. We evaluated the number of CD34(+), CD34(+)/CD38(-), CD3(+), CD4(+), CD8(+), CD19(+), CD56(+)/CD3(-), CD4(+)/CD25(+)/FOXP3(+), and CD138(+)/CD38(+) cells on each apheresis. Hematological and immunological recovery were determined at 30 days, 3, 6, 9, and 12 months after ASCT. Overall, 34/37 patients mobilized a median of 10.1 × 10(6) CD34(+) cells/Kg (IQ 7.7-13.4). Patients with <20/µL CD34(+) cells at plerixafor administration (18/33) had a significantly higher CD34(+) cell fold increase, but not a higher absolute number, than 16/33 patients with ≥20/µL CD34(+) cells. A similar CD34(+) and immune graft composition was reported. A higher number of CD3(+) and CD8(+) cells/µL was observed at 3 months after first ASCT (p < 0.05) in the group with ≥20 CD34(+) cells/µL. Thus, in MM patients, the timing of plerixafor administration influences immunological recovery.

The timing of plerixafor addition to G-Csf and chemotherapy affects immunological recovery after autologous stem cell transplant in multiple myeloma

Tolomelli, Giulia;Mancuso, Katia;Tacchetti, Paola;Pantani, Lucia;Zannetti, Beatrice;Motta, Maria Rosa;Dan, Elisa;Sinigaglia, Barbara;Giudice, Valeria;Arpinati, Mario;Chirumbolo, Gabriella;Lewis, Russell E;Bonifazi, Francesca;Cavo, Michele;Curti, Antonio;Lemoli, Roberto M
2020

Abstract

Plerixafor inhibits CXCR4, thus inducing the mobilization of hematopoietic stem/progenitor cells in lymphoma and multiple myeloma (MM) patients eligible for autologous stem cell transplantation (ASCT). However, the kinetics of plerixafor-induced mobilization of lymphocyte subsets is poorly known. Here, we evaluated the graft content, the engraftment, and the immunological reconstitution of MM patients receiving plerixafor. Thirty-seven patients undergoing one or tandem ASCT were enrolled. After mobilization with cyclophosphamide plus G-CSF, plerixafor was added at hematological recovery regardless of CD34(+) cell count. We evaluated the number of CD34(+), CD34(+)/CD38(-), CD3(+), CD4(+), CD8(+), CD19(+), CD56(+)/CD3(-), CD4(+)/CD25(+)/FOXP3(+), and CD138(+)/CD38(+) cells on each apheresis. Hematological and immunological recovery were determined at 30 days, 3, 6, 9, and 12 months after ASCT. Overall, 34/37 patients mobilized a median of 10.1 × 10(6) CD34(+) cells/Kg (IQ 7.7-13.4). Patients with <20/µL CD34(+) cells at plerixafor administration (18/33) had a significantly higher CD34(+) cell fold increase, but not a higher absolute number, than 16/33 patients with ≥20/µL CD34(+) cells. A similar CD34(+) and immune graft composition was reported. A higher number of CD3(+) and CD8(+) cells/µL was observed at 3 months after first ASCT (p < 0.05) in the group with ≥20 CD34(+) cells/µL. Thus, in MM patients, the timing of plerixafor administration influences immunological recovery.
2020
Tolomelli, Giulia; Mancuso, Katia; Tacchetti, Paola; Patriarca, Francesca; Galli, Monica; Pantani, Lucia; Zannetti, Beatrice; Motta, Maria Rosa; Rizzi, Simonetta; Dan, Elisa; Sinigaglia, Barbara; Giudice, Valeria; Olmo, Andrea; Arpinati, Mario; Chirumbolo, Gabriella; Fanin, Renato; Lewis, Russell E; Paris, Laura; Bonifazi, Francesca; Cavo, Michele; Curti, Antonio; Lemoli, Roberto M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/734980
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