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Predictors of poor haematopoietic stem cell mobilisation in patients with haematological malignancies at a South African centre.
du Toit, Justin; Goeijenbier, Marco; du Toit, Cecile; de Witt, Pieter; Koornhof, Hannes; Oosthuizen, Jenna; Louw, Vernon Johan; Seftel, Matthew; Verburgh, Estelle.
Afiliação
  • du Toit J; Cellular and Immunotherapy Centre, Wits Donald Gordon Medical Centre, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Division of Clinical Haematology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, So
  • Goeijenbier M; Department of Internal medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
  • du Toit C; Division of Clinical Haematology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • de Witt P; Division of Clinical Haematology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Koornhof H; Division of Clinical Haematology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Oosthuizen J; Division of Clinical Haematology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Louw VJ; Division of Clinical Haematology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Seftel M; Division of Haematology, Department of Medicine, University of British Columbia, Vancouver, Canada.
  • Verburgh E; Division of Clinical Haematology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Transfus Apher Sci ; 61(4): 103419, 2022 Aug.
Article em En | MEDLINE | ID: mdl-35288051
ABSTRACT

BACKGROUND:

Autologous stem cell transplant (ASCT) is an established consolidation strategy in the treatment of haematological malignancies, however poor mobilisation (PM) can contribute to patient morbidity and high resource utilisation. Identifying the incidence, risk factors for PM and engraftment outcomes are important goals in our resource limited setting.

METHODS:

We retrospectively analyzed patients with haematological malignancies that consecutively underwent ASCT at Groote Schuur hospital, Cape Town, South Africa from January 2013 to January 2019.

RESULTS:

146 patients - majority with multiple myeloma (MM)(41,8%), FM= 12, underwent leukapheresis with median age of 32 years (range, 9 - 66 years). PM occurred in 25/146 (17%), mobilisation failure (MF) in 3/146 (2%) and super mobilisation (SMs) in 99/146 (68%), respectively. Risk factors for PM were diagnosis of acute leukaemia (RR = 25, 95% CI 3.4 - 183, p = 0.002) and Hodgkin lymphoma (RR = 19, 95% CI 2.6 - 142, p = 0.004); low white cell count (WCC) at harvest (WCC < 9 × 109/L (RR=4.3, 95% CI 2.3 - 8.3, p < 0.0001) and two vs one line of prior therapy (RR = 3.1, 95% CI 1.45 - 6.7, p = 0.0037). Median days to neutrophil and platelet engraftment were 14 days (95% CI 14-15 days) and 16 days (95% CI 15-16 days) respectively.

CONCLUSION:

PM occurred in 17% of a contemporary South African ASCT cohort, albeit with a low MF rate (2%). There was surprisingly high rate (68%) of SMs, possibly reflective of superfluous mobilisation strategy in MM patients. We identified predictive factors for PM that will lead to enhanced cost-effective use of plerixafor.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Leucemia Mieloide Aguda / Transplante de Células-Tronco Hematopoéticas / Neoplasias Hematológicas / Compostos Heterocíclicos / Mieloma Múltiplo Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Child / Humans / Middle aged País/Região como assunto: Africa Idioma: En Revista: Transfus Apher Sci Assunto da revista: HEMATOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Somália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Leucemia Mieloide Aguda / Transplante de Células-Tronco Hematopoéticas / Neoplasias Hematológicas / Compostos Heterocíclicos / Mieloma Múltiplo Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Child / Humans / Middle aged País/Região como assunto: Africa Idioma: En Revista: Transfus Apher Sci Assunto da revista: HEMATOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Somália