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Autologous haematopoietic stem cell mobilisation in multiple myeloma and lymphoma patients: a position statement from the European Group for Blood and Marrow Transplantation

Bone Marrow Transplantation volume 49, pages 865–872 (2014)Cite this article

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Abstract

Autologous haematopoietic SCT with PBSCs is regularly used to restore BM function in patients with multiple myeloma or lymphoma after myeloablative chemotherapy. Twenty-eight experts from the European Group for Blood and Marrow Transplantation developed a position statement on the best approaches to mobilising PBSCs and on possibilities of optimising graft yields in patients who mobilise poorly. Choosing the appropriate mobilisation regimen, based on patients’ disease stage and condition, and optimising the apheresis protocol can improve mobilisation outcomes. Several factors may influence mobilisation outcomes, including older age, a more advanced disease stage, the type of prior chemotherapy (e.g., fludarabine or melphalan), prior irradiation or a higher number of prior treatment lines. The most robust predictive factor for poor PBSC collection is the CD34+ cell count in PB before apheresis. Determination of the CD34+ cell count in PB before apheresis helps to identify patients at risk of poor PBSC collection and allows pre-emptive intervention to rescue mobilisation in these patients. Such a proactive approach might help to overcome deficiencies in stem cell mobilisation and offers a rationale for the use of novel mobilisation agents.

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Acknowledgements

Medical writing and editorial assistance was provided by Marianne Jenal-Eyholzer, PhD, CMPP, from ETICHO (European Training in Clinical Hematology and Oncology), The Hague, The Netherlands, funded by an unrestricted grant from Sanofi. The authors are fully responsible for the content of this manuscript.

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Author notes

  1. M Mohty, K Hübel, N Kröger, M Aljurf, J Apperley, G W Basak, A Bazarbachi, K Douglas, I Gabriel, L Garderet, C Geraldes, O Jaksic, M W Kattan, Z Koristek, F Lanza, R M Lemoli, L Mendeleeva, G Mikala, N Mikhailova, A Nagler, H C Schouten, D Selleslag, S Suciu, A Sureda, N Worel, P Wuchter, C Chabannon and R F Duarte: All these authors contributed equally to this work.

Authors and Affiliations

  1. Department of Haematology, Saint Antoine Hospital, Paris, France

    M Mohty & L Garderet

  2. University Hospital Cologne, Cologne, Germany

    K Hübel

  3. University Hospital Hamburg-Eppendorf, Hamburg, Germany

    N Kröger

  4. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

    M Aljurf

  5. Imperial College London, London, UK

    J Apperley & I Gabriel

  6. The Medical University of Warsaw, Warsaw, Poland

    G W Basak

  7. American University of Beirut, Beirut, Lebanon

    A Bazarbachi

  8. Beatson West of Scotland Cancer Centre, Glasgow, UK

    K Douglas

  9. University Hospital Coimbra, Coimbra, Portugal

    C Geraldes

  10. University Hospital Dubrava, Zagreb, Croatia

    O Jaksic

  11. Quantitative Health Sciences Cleveland Clinic, Cleveland, OH, USA

    M W Kattan

  12. Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic

    Z Koristek

  13. Cremona Hospital, Cremona, Italy

    F Lanza

  14. University of Genoa, Genoa, Italy

    R M Lemoli

  15. National Research Centre for Haematology, Moscow, Russia

    L Mendeleeva

  16. St Istvan and St Laszlo Hospital, Budapest, Hungary

    G Mikala

  17. Institute of Children Haematology and Transplantation n.a. R Gorbacheva, St Petersburg State Pavlov Medical University, St Petersburg, Russia

    N Mikhailova

  18. Chaim Sheba Medical Center, Tel, Hashomer, Israel

    A Nagler

  19. Maastricht University Medical Centre, Maastricht, The Netherlands

    H C Schouten

  20. Department of Haematology, AZ Sint-Jan, Brugge-Oostende, Belgium

    D Selleslag

  21. EORTC Headquarters, Brussels, Belgium

    S Suciu

  22. Addenbrooke's Hospital, Cambridge, UK

    A Sureda

  23. Medical University Vienna, Vienna, Austria

    N Worel

  24. Department of Medicine V, Heidelberg University, Heidelberg, Germany

    P Wuchter

  25. Institut Paoli-Calmettes and Inserm CBT-510, Marseille, France

    C Chabannon

  26. Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain

    R F Duarte

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  1. M Mohty
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Correspondence to M Mohty.

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Competing interests

MM: Research support and honoraria from Sanofi, Amgen and Chugai, whose products are discussed here. KH: Consulting fee or honorarium and support for travel to meetings from Genzyme/Sanofi; board membership for Pfizer and Noxxon; payment for lectures including service on speakers’ bureaus from Janssen; and travel/accommodations/meeting expenses unrelated to activities listed from Roche. NK: Honorarium for lectures from Sanofi; and consultant fee from Noxxon. MA: Consulting fee or honorarium from ETICHO. GWB: Sponsorship for participation in scientific conferences from Sanofi; membership of Mozobil advisory boards for Sanofi; and reimbursements for trainings from Sanofi. AB: Honoraria from Sanofi whose products are discussed here. KD: Speaker’s fees and honoraria for medical advisory board work from Genzyme and Sanofi Europe between 2009 and 2012 inclusive. GL: Consulting fee or honorarium from ETICHO. CG: None disclosed. OJ: Consulting fee or honorarium from ETICHO; and consultancy for Sanofi. MWK: consultancy for GlaxoSmithKline, Bayer and Merck. ZK: Consultancy for CEEOR; payment for lectures including service on speakers’ bureaus from Sanofi-Aventis; and travel/accommodations/meeting expenses unrelated to activities listed from Sanofi-Aventis. RML: Payment for lectures including service on speakers’ bureaus from Sanofi; and consultancy and board membership for Sanofi. GM: Grant and fees for participation in review activities such as data monitoring boards, statistical analysis, end point committees and the like from ETICHO; support for travel to meetings or other purposes from Genzyme; expert testimony for Janssen and ETICHO; and payment for lectures including service on speakers’ bureaus from Janssen. AN: Research grant from Genzyme/Sanofi; and honorarium for participating in a scientific advisory board. HCS: Membership of an advisory board for Sanofi. DS: Honoraria and research grants from Genzyme and Amgen; and membership of advisory boards for Genzyme and Amgen. AS: Participation in Sanofi-organised advisory boards. NW: Speaker’s fee from Sanofi and membership of the advisory board. PW: Honorarium for lectures from Sanofi; and consulting fee or honorarium from ETICHO. CC: Consultancy for Terumo BCT, Novartis and Sanofi-Genzyme; and membership of an advisory board for Sanofi-Genzyme. RFD: Consultancy for Sanofi-Genzyme, Amgen and Italfarmaco; and payment for lectures including service on speakers’ bureaus from Sanofi-Genzyme, Amgen and Italfarmaco. JA, IG, FL, NM, LM and SS: no relevant conflicts of interest.

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Mohty, M., Hübel, K., Kröger, N. et al. Autologous haematopoietic stem cell mobilisation in multiple myeloma and lymphoma patients: a position statement from the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 49, 865–872 (2014). https://doi.org/10.1038/bmt.2014.39

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  • DOI: https://doi.org/10.1038/bmt.2014.39

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