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Stem Cell Mobilization and Harvesting Failure in Case of Heavily Pretreated Patients

. Pozotrigo M, Adel N, Landau L, et al. Factors impacting stem cell mobilization failure rate and efficiency in multiple myeloma in the area of novel therapies: experience at Memorial Sloan Kattering Cancer Center. Bone Marrow Transplantation . 2013;48:1033-1039. 9. Worel N, Rosskopf K, Neumeister P, et al. Plerixafor and granulocyte-colony-stimulating factor (G-CSF) in patients with lymphoma and multiple myeloma previously failing mobilization with G-CSF with or without chemotherapy for autologous hematopoietic stem cell mobilization: the Austrian experience on a

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Plerixafor for patients who fail cytokine-or chemotherapy-based stem cell mobilization: Results of a prospective study by the Polish Lymphoma Research Group (PLRG)

identify factors associated with the risk of mobilization failure. The first prognostic system was elaborated by Gruppo Italiano Trapianto di Midollo Osseo in 2012 [ 11 ]. More recently, Olivieri et al [ 12 ] built on real large representative data a score to “rule in” patients at very high risk for poor mobilizers before starting mobilization, allowing changes in clinical management, to avoid highly likely mobilization failure. Predicted poor mobilizer score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before

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New Treatment Methods in Multiple Myeloma

therapy for multiple myeloma in actual clinical practice. Korean J Intern Med. 2016;31:809-819. 14. Kyle R, Rajkumar S. Treatment of Multiple Myeloma: A Comprehensive Review. Clin Lymphoma Myeloma . 2009;9:278-288. 15. Uy G, Rettig M, Cashen A. Plerixafor, a CXCR4 antagonist for the mobilization of hematopoietic stem cells. Expert Opin Biol Ther . 2008;8:1797-1804. 16. Mehdizadeh M, Hajifathali A, Tabarraee M, et al. Plerixafor in the Treatment of Stem Cell Mobilization Failure; First Experience in Iran. Iran J Pharm Res . 2013;12:189-191. 17

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Mobilization with cyclophosphamide reduces the number of lymphocyte subpopulations in the leukapheresis product and delays their reconstitution after autologous hematopoietic stem cell transplantation in patients with multiple myeloma

were excluded from further evaluation. All three were salvaged with plerixafor and successfully underwent AHSCT. No patient failed mobilization with cyclophosphamide. All transplanted patients successfully engrafted. Discussion The use of cyclophosphamide mobilization in MM patients results in lower mobilization failure, higher stem cell yield and fewer collection procedures but at the cost of higher toxicity. 6 , 9 , 10 Furthermore, cyclophosphamide affects lymphocyte subpopulations possibly affecting the response after AHSCT. In our study, we prospectively

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