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Clinical Trial
. 2024 Dec;103(12):5799-5805.
doi: 10.1007/s00277-024-06103-1. Epub 2024 Nov 25.

Plerixafor in association with R-DHAP and G-CSF to mobilize a large number of CD34 + cells in patients with relapsed-refractory diffuse large B-cell lymphomas

Francesco Gaudio  1   2 , Anna Mele  3 , Eleonora Prete  3 , Filomena Emanuela Laddaga  4 , Alessandro Maggi  5 , Nicola Di Renzo  6 , Giuseppe Milone  7 , Angelo Ostuni  8 , Vincenzo Pavone  3
Affiliations
Clinical Trial

Plerixafor in association with R-DHAP and G-CSF to mobilize a large number of CD34 + cells in patients with relapsed-refractory diffuse large B-cell lymphomas

Francesco Gaudio et al. Ann Hematol. 2024 Dec.

Abstract

Lymphoma and plasma cell disorders are the most common indications for autologous hematopoietic stem cell (HSC) transplantation. We conducted a prospective multicenter study with the aim of testing the feasibility of plerixafor (PLX) in combination with R-DHAP and G-CSF in 37 patients with relapsed refractory diffuse large B-cell lymphoma (R/R DLBCL) in order to collect a large number of HSC with a goal of transplantation. After R-DHAP, daily monitoring of peripheral blood CD34 + cells by flow cytometry was performed starting on day + 13. If, on day + 14, peripheral blood CD34 + cells were > 20 × 10e6/L apheresis was started, if they were < 20 × 10e6/L and WBC > 4.0 × 10e9/L, PLX was administered. Results: The median CD34 + cell count collected was 10.5 × 10e6/kg (range 0-51). 81% of patients achieved the minimum CD34 + target cell count of 6 × 10e6/kg. 66% of patients required only one apheresis to achieve collection goals. The rate of engraftment was 10 days for neutrophils > 0.5 × 10e9/L and 13 days for platelets > 20 × 10e9/L. In conclusion, the addition of PLX to salvage therapy in patients with R/R DLBCL is effective and may be routinely used in the future to increase the number of CD34 + cells collected and minimize the risk of poor mobilization.

Keywords: Apheresis; Lymphoma, relapsing refractory; Poor mobilization; Stem cell transplantation.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Author contributions: FG, AO and VP conceived and designed the study. AMaggi, NDR, GM and EP acquired the data. FG, AM, FEL and VP analysed and interpreted the data. AM, FEL and FG drafted the manuscript. All authors revised the manuscript. All authors read and approved the final manuscript. Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki. Ethical review and approval were waived for this study: since the study data were collected during routine clinical activity and fully anonymized, a formal institutional review board approval was exempted. Informed consent statement: Each patient enrolled in this study was informed about the procedures and signed consent to allow data collection and analysis for research purposes.

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