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Benefits of Pre-harvest Peripheral Blood CD34 Counts Guided Single Dose Therapy with PLERIXAFOR in Autologous Hematopoietic Stem Cell Transplantation: A Retrospective Study at a Tertiary Care Institute in India

  • Poojan Agarwal
  • Narender TejwaniEmail author
  • Amardeep Pathak
  • Dushyant Kumar
  • Narendra Agrawal
  • Anurag Mehta
Original Article
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Abstract

Peripheral blood is a convenient source of stem cells for hematopoietic stem cell transplantation. However, in autologous transplants, the harvest failure rates are high because of inadequate mobilization using G-CSF alone. Plerixafor is a potent mobilizer when used with G-CSF. However, its routine use is limited by high cost. This is a retrospective study done at a tertiary care oncology centre in India. All the harvest records were analyzed between Jan 2015 and Nov 2017. May 2016 onwards pre-harvest peripheral blood CD34 count was done in all cases of autologous transplants on day 4 of G-CSF therapy and they were given a single dose of Plerixafor if counts were < 20 cell per cumm. The results were compared amongst various groups. A total of 321 cases were analyzed. 172/321 were allogenic transplant cases of which 5% (n = 7) failed to achieve a target live stem cell dose of > 2 million per kg of the recipient. The overall failure rate in autologous group (n = 149) was 27% (n = 41) (p ≤ 0.001 auto vs. allo). The failure rate was higher (36%, n = 28/77) when no intervention with Plerixafor was done. The overall failure rate in the group treated with pre-harvest 34 count based single dose therapy of Plerixafor was 18% (n = 13/72, p = 0.01). However, within this intervention group, the patients who had pre-harvest peripheral blood CD34 above the desired cutoff had a higher failure rate of 21% (p = 0.13). Pre-harvest CD34 count based intervention with Plerixafor help optimizing the cost.

Keywords

Plerixafor ISHAGE CD34 

Notes

Funding

The study is the retrospective analysis of the data of patients at the Rajiv Gandhi Cancer Hospital and Research Institute. No funding received. None of the authors has any financial relationship with any organization for current study as no sponsorship is received.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study involves a retrospective analysis of data and no animal subjects were involved.

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Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  • Poojan Agarwal
    • 1
  • Narender Tejwani
    • 1
    Email author
  • Amardeep Pathak
    • 2
  • Dushyant Kumar
    • 2
  • Narendra Agrawal
    • 3
  • Anurag Mehta
    • 1
  1. 1.Department of Laboratory MedicineRajiv Gandhi Cancer Institute and Research CenterRohiniIndia
  2. 2.Department of PathologyRajiv Gandhi Cancer Institute and Research CenterRohiniIndia
  3. 3.Department of HematologyRajiv Gandhi Cancer Institute and Research CenterRohiniIndia

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