<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2016-0028_s_101_w2aab3b8b2b1b7b1aab1c15b1Aa"><h3>Background</h3><p>Autologous hematopoietic stem cell transplantation is considered the standard of care for younger patients with multiple myeloma. Several mobilization regimens are currently used, most commonly growth factors alone or in combination with chemotherapy. The aim of our study was to investigate the differences in lymphocyte subpopulation counts between three different mobilization regimens on collection day, in the leukapheresis product and on day 15 after autologous hematopoietic stem cell transplantation.</p></sec><sec id="j_raon-2016-0028_s_102_w2aab3b8b2b1b7b1aab1c15b2Aa"><h3>Patients and methods</h3><p>In total 48 patients were prospectively enrolled in three different mobilization regimens; (i) filgrastim (20), (ii) pegfilgrastim (19) and (iii) cyclophosphamide + filgrastim (9). Lymphocytes, CD16+/56+ natural killer and CD4+/CD25<sup>high</sup> T regulatory cells were determined by flow cytometry.</p></sec><sec id="j_raon-2016-0028_s_103_w2aab3b8b2b1b7b1aab1c15b3Aa"><h3>Results</h3><p>We found a statistically significant difference between the mobilization regimens. Cyclophosphamide reduced lymphocyte and natural killer (NK) cell counts on collection day (lymphocytes 1.08 × 10<sup>9</sup>/L; NK cells 0.07 × 10<sup>9</sup>/L) compared to filgrastim (lymphocytes 3.08 × 10<sup>9</sup>/L; NK cells 0.52 × 10<sup>9</sup>/L) and pegfilgrastim (lymphocytes 3 × 10<sup>9</sup>/L; NK cells 0.42 × 10<sup>9</sup>/L). As a consequence lymphocyte and NK cell counts were also lower in the leukapheresis products following cyclophosphamide mobilization regimen (lymphocytes 50.1 × 10<sup>9</sup>/L; NK cells 4.18 × 10<sup>9</sup>/L) compared to filgrastim (lymphocytes 112 × 10<sup>9</sup>/L; NK cells 17.5 × 10<sup>9</sup>/L) and pegfilgrastim (lymphocytes 112 × 10<sup>9</sup>/L; NK cells 14.3 × 10<sup>9</sup>/L). In all mobilization regimens T regulatory cells increased 2-fold on collection day, regarding the base line value before mobilization. There was no difference in T regulatory cell counts between the regimens.</p></sec><sec id="j_raon-2016-0028_s_104_w2aab3b8b2b1b7b1aab1c15b4Aa"><h3>Conclusions</h3><p>Mobilization with cyclophophamide reduces the number of mobilized and collected lymphocytes and NK cells as compared to mobilization with growth factors only and results in their delayed reconstitution following autologous hematopoietic stem cell transplantation. We found no difference between filgrastim and pegfilgrastim mobilization.</p></sec></abstract>

BackgroundAutologous hematopoietic stem cell transplantation is considered the standard of care for younger patients with multiple myeloma. Several mobilization regimens are currently used, most commonly growth factors alone or in combination with chemotherapy. The aim of our study was to investigate the differences in lymphocyte subpopulation counts between three different mobilization regimens on collection day, in the leukapheresis product and on day 15 after autologous hematopoietic stem cell transplantation.Patients and methodsIn total 48 patients were prospectively enrolled in three different mobilization regimens; (i) filgrastim (20), (ii) pegfilgrastim (19) and (iii) cyclophosphamide + filgrastim (9). Lymphocytes, CD16+/56+ natural killer and CD4+/CD25high T regulatory cells were determined by flow cytometry.ResultsWe found a statistically significant difference between the mobilization regimens. Cyclophosphamide reduced lymphocyte and natural killer (NK) cell counts on collection day (lymphocytes 1.08 × 109/L; NK cells 0.07 × 109/L) compared to filgrastim (lymphocytes 3.08 × 109/L; NK cells 0.52 × 109/L) and pegfilgrastim (lymphocytes 3 × 109/L; NK cells 0.42 × 109/L). As a consequence lymphocyte and NK cell counts were also lower in the leukapheresis products following cyclophosphamide mobilization regimen (lymphocytes 50.1 × 109/L; NK cells 4.18 × 109/L) compared to filgrastim (lymphocytes 112 × 109/L; NK cells 17.5 × 109/L) and pegfilgrastim (lymphocytes 112 × 109/L; NK cells 14.3 × 109/L). In all mobilization regimens T regulatory cells increased 2-fold on collection day, regarding the base line value before mobilization. There was no difference in T regulatory cell counts between the regimens.ConclusionsMobilization with cyclophophamide reduces the number of mobilized and collected lymphocytes and NK cells as compared to mobilization with growth factors only and results in their delayed reconstitution following autologous hematopoietic stem cell transplantation. We found no difference between filgrastim and pegfilgrastim mobilization.

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

Department of hematology, University Medical Center Ljubljana, Ljubljana,

Radiology and Oncology

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

BackgroundAutologous hematopoietic stem cell transplantation is considered the standard of care for younger patients with multiple myeloma. Several...

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

Article Category: Research Article

Published Online: May 12, 2016

Page range: 402 - 408

Received: Oct 19, 2015

Accepted: Jan 31, 2016

DOI: https://doi.org/10.1515/raon-2016-0028

Keywords
mobilization, myeloma, cyclophosphamide, NK cell, stem cell transplantation

© 2016 Radiol Oncol

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Article Category: Research Article

Published Online: May 12, 2016

Page range: 402 - 408

Received: Oct 19, 2015

Accepted: Jan 31, 2016

DOI: https://doi.org/10.1515/raon-2016-0028

Keywordsmobilization, myeloma, cyclophosphamide, NK cell, stem cell transplantation

© 2016 Radiol Oncol

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords
mobilization, myeloma, cyclophosphamide, NK cell, stem cell transplantation