Despite the Use of the Combination of G-CSF and Plerixafor for Stem Cell Mobilization, One Third of the Patients with Lymphoma Were Still "Poor Mobilizer" Using the Criteria Recently Proposed by GITMO (< 2.0 X 106 CD 34 + Cells Per Kg in ≤ 3 Apheresis)

H.C. Fung, J. Tornatta, B. McLeod, S. Nathan, J. Maciejewski, E. Rich, R. Karmali, A. Jimenez, K.W. Christopherson, S.A. Gregory
2012 Biology of Blood and Marrow Transplantation  
PFS (53% vs 13%, p 5 0,004). Day 100 chimerism does not predict incidence of cGVHD, relapse, or overall survival. Day 56 chimerism result was higher for patient who experienced aGVHD (median 89% vs 78%, p 5 0,048) and was associated with better OS if less than 82.5% (84% vs 53%, p 5 0,01). Conclusion: Limiting CD34 cell dose could lower incidence of cGVHD presumably without influencing relapse incidence and overall survival, while limiting CD3 cell dose could improve survival. Early evaluation
more » ... f chimerism at day 56 is relevant to identify patients who will experience aGVHD and predict survival. 160 STEM CELL TRANSPLANT ADVERSE REACTIONS (STAR) ANALYSIS: DOES A HIGHER INFUSION RED BLOOD CELL CONTENT CORRELATE WITH SE-RIOUS ADVERSE EVENTS? Vidula, N., Villa, M., Mehboob, M., Jovanovic, B., Meagher, R., Gordon, L.I. Northwestern University Feinberg School of Medicine, Chicago, IL Introduction: Stem cell transplantation has emerged as a treatment option for patients with hematologic malignancies. With transplantation, however, there is a risk of adverse events associated with the stem cell infusion. These events were previously attributed to the cryoprotectant used in cell preparation, but the persistence of these events with cryoprotectant depletion suggests the involvement of other factors. Recently, the red blood cell content of stem cell infusions has been implicated in transplant related adverse events including bradycardia and renal toxicity. We analyzed the Northwestern University transplant experience to determine whether the red blood cell content of an infusion correlated with serious adverse reactions such as stroke and seizure. Methods: We conducted a retrospective chart review of all hematologic malignancy patients at our center who received stem cell transplants between 1/1/08 and 5/1/11. Detailed patient and infusion characteristics were collected. Results: We identified 462 hematologic malignancy patients who received stem cell transplants. The mean red blood cell content per kilogram body weight of the stem cell infusion for the entire population was 0.25 mL/kg 6 .34 (range 0.02-4.32 mL/kg). Five patients had serious adverse reactions including stroke (3 patients), seizure (1 patient), and nausea, vomiting, and flushing (1 patient). The mean red blood cell content per kilogram body weight of the stem cell infusion for these 5 patients with serious adverse events was 0.34 mL/ kg 6 0.20 (range 0.13-0.63). Conclusions: Our preliminary results suggest that serious adverse events at the time of stem cell transplantation are generally rare, but can be devastating. We note a slightly higher red blood cell content amongst those patients experiencing these types of events compared to the study population as a whole. However, further study is ongoing to determine whether there is a correlation between RBC content and serious adverse events at the time of stem cell re-infusion.
doi:10.1016/j.bbmt.2011.12.175 fatcat:2qcentm4zjeofhldqkf5izkim4