Presentation is loading. Please wait.

Presentation is loading. Please wait.

Collection of peripheral blood stem cells Dr Kacem Karima Department of clinical haematology -HAO CMH - 26/05/2012.

Similar presentations


Presentation on theme: "Collection of peripheral blood stem cells Dr Kacem Karima Department of clinical haematology -HAO CMH - 26/05/2012."— Presentation transcript:

1 Collection of peripheral blood stem cells Dr Kacem Karima Department of clinical haematology -HAO CMH - 26/05/2012

2 High-dose chemotherapy with peripheral blood stem cell support: best option for a high risk group of patients Mobilized peripheral blood stem cells (PBSC): main source for autologous SCT. Successful engraftment relies on CD34+progenitor cell dose. Critical step: effective PBSC mobilization but 15- 30% of patients fail to mobilize.

3 Aims of this study: Analysis of mobilized patients profiles. Review of our strategies for collection of PBSC. Establish the influence of certain factors on the outcome of PBSC mobilization

4 Retrospective analysis Patients with lymphoma (HL, NHL) January 2005 - December 2011 Haematology department of Aziza Othmana Hospital

5 RESULTS

6 H/F53/41 (sex ratio :1.29) Median Age33 (14 – 61) HL44 NHL50 Stage III/IV Initial BM involvement 74(78%) 15 (16%) Nb of patients : 94 Nb of mobilizations : 104 Criterion for adequate mobilization: at least 2.0 x 10 6 CD34+ cells/kg of patient. Leukapheresis: Nb CD34+(PB)≥ 20/mm 3

7 RefractoryRelapsedTotal CHL291544 Responsive Relapse or refractory Disease NHL440650

8 Treatment characteristics Previous RT6 Median nb of regimens of CT2 ( 1 – 4 ) Median nb of previous CT courses5 (2 – 12 )

9 93 patients: mobilized with a combination of chemotherapy and growth factors (G-CSF) - 5γ/kg/day 28 pts 30% - 5 puis 10γ/kg/day 62pts 66.6% - 10 γ/kg/day 3 pts 3.2% One patient with G-CSF only.

10 Median delay/CT Median delay /G-CSF 15 days(10-28) 9 days (4-22) Nb median leukapheresis1.45 (1 – 3) Nb median collected CD34+6 10 6 /kg (1.37- 30.6 10 6 /kg) % failure5.3 %

11 Nb CD34 10 6 /kgp Age (years)0.05 > 504.96±2.24 < 508.54±6.34 Gender0.34 M8.59±6.58 F7.34±5.33 BOM0.25 Involved6.2±4.6 Normal8.34±6.25 RC at mobilization0.28 Yes8.91±7.5 No7.4±4.91 Nb of cycles of CT0.09 < 67.29 ± 5.35 > 69.6 ± 7.18 Hb (g/dl)0.83 < 117.86 ± 6.2 > 118.15 ± 6.06

12 Correlation between dose G-CSF and Nb CD34 collected Dose (γ/kg/d)p 55.81±3.220.015 5 then 109.1±6.66

13 1st PBSC COLLECTION LENOGRASTIMFILGRASTIMp Median nb of CD34+ Cells mobilized 8.86 10 6 /kg7.74 10 6 /kg0.2

14

15

16

17 Proven poor mobilizer (GITMO) Peak CD34+ circulating cell count < 20/μl with less than 2 10 6 harvested CD34+ cells/kg

18 Predicted poor mobilizer (GITMO): at least one major criterion or two minor criteria: Major criteria: -Failed previous mobilisation -Prior extensive therapy -Previous therapy: fluda, melphalan Minor criteria -At least 2 prior cytotoxic lines -Refractory disease -Extensive BM involvement at mobilisation -Age > 65 years -BM cellularity < 30% at mobilisation

19 Failures: 5 in study period 5 between January and May 2012 /13 pts Predictive factors of failure Myelofibrosis1pt Refractory Disease3 pts Prior lines of CT ≥ 23 pts Nb cycles ≥ 63 pts Previous RT2 pts

20 CONCLUSION: -Peripheral CD34 count is a useful predictor for both harvest timing and successful collection of PBSC. -Identify poor mobilizers patients -G-CSF et Plerixafor : suitable combination for failure collection


Download ppt "Collection of peripheral blood stem cells Dr Kacem Karima Department of clinical haematology -HAO CMH - 26/05/2012."

Similar presentations


Ads by Google