Abstract
Objective: Autologous peripheral blood haemopoietic stem cell (PBSC) transplantation is a standard therapeutic option for eligible patients with lymphoproliferative disease (LPD). The prerequisite for autologous PBSC transplantation is the successful stem cell mobilization. This study is aimed to determine the factors associated with poor PBSC mobilization in LPD patient at our center.
 Materials and methods: This retrospective record review involved 39 multiple myeloma (MM) and 92 of lymphoma patients who had undergone PBSC mobilization from January 2009 until December 2016. Patients were mobilized with combination chemotherapy and granulocyte colony stimulating factor. Factors affecting mobilization including patient’s, disease and treatment characteristics werestudied.
 Results: Majority of patients were Malay (93.9%) with the mean age at mobilization of 41.4 years. The mean of CD34+ cell dosage was 9.6x106 cells/kg. Successful and poor mobilization was found to be 90.8% and 9.2% respectively. Multivariate analysis showed that the significant risk factors for poor mobilization were age of ≥ 60 years (adjusted OR=38.43, p=0.005) and PB CD34+ cell count, <20 cells/uL (adjusted OR=132.69, p<0.001).
 Conclusion:PB CD34+ cell count and age ≥ 60years were the main risk factors for poor PBSC mobilization. Thus, alternative strategies of mobilization is needed to reduce risk of poor mobilization in a such group of patient.
 Bangladesh Journal of Medical Science Vol.19(3) 2020 p.458-466
Highlights
Salvage chemotherapy followed by autologous peripheral blood haematopoietic stem transplantation (APBSCT) is globally accepted as the standard of care for lymphoproliferative disorder (LPD) namely multiple myeloma (MM), non-Hodgkin lymphoma (NHL) and relapsed Hodgkin lymphoma (HL) patients[1,2]
Lymphoma patient underwent peripheral blood haemopoietic stem cell (PBSC) mobilization at younger age compare to MM patient and was statistically significant (p
Our result showed that the diagnosis and stage of disease were not a risk factor for poor mobilization, but we found that 11 out of 12 poor mobilized patients were lymphoma and majority were NHL (9 patients)
Summary
Salvage chemotherapy followed by autologous peripheral blood haematopoietic stem transplantation (APBSCT) is globally accepted as the standard of care for lymphoproliferative disorder (LPD) namely multiple myeloma (MM), non-Hodgkin lymphoma (NHL) and relapsed Hodgkin lymphoma (HL) patients[1,2]. 1. Mohd Nazri Hassan, Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia & Hospital USM, Health Campus, USM, 16150 Kubang Kerian, Kelantan, Malaysia. 2. Azlan Husin, Hospital USM, Health Campus, USM, 16150 Kubang Kerian, Kelantan, Malaysia & Department of Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. 3. Rapiaah Mustaffa, Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia & Hospital USM, Health Campus, USM, 16150 Kubang Kerian, Kelantan, Malaysia. 4. Rosline Hassan, Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia & Hospital USM, Health Campus, USM, 16150 Kubang Kerian, Kelantan, Malaysia
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