Proposed definition of 'poor mobilizer' in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo ItalianoTrapianto di Midollo Osseo

Bone Marrow Transplant. 2012 Mar;47(3):342-51. doi: 10.1038/bmt.2011.82. Epub 2011 May 30.

Abstract

Many lymphoma and myeloma patients fail to undergo ASCT owing to poor mobilization. Identification of poor mobilizers (PMs) would provide a tool for early intervention with new mobilization agents. The Gruppo italianoTrapianto di Midollo Osseo working group proposed a definition of PMs applicable to clinical trials and clinical practice. The analytic hierarchy process, a method for group decision making, was used in setting prioritized criteria. Lymphoma or myeloma patients were defined as 'proven PM' when: (1) after adequate mobilization (G-CSF 10 μg/kg if used alone or ≥5 μg/kg after chemotherapy) circulating CD34(+) cell peak is <20/μL up to 6 days after mobilization with G-CSF or up to 20 days after chemotherapy and G-CSF or (2) they yielded <2.0 × 10(6) CD34(+) cells per kg in ≤3 apheresis. Patients were defined as predicted PMs if: (1) they failed a previous collection attempt (not otherwise specified); (2) they previously received extensive radiotherapy or full courses of therapy affecting SC mobilization; and (3) they met two of the following criteria: advanced disease (≥2 lines of chemotherapy), refractory disease, extensive BM involvement or cellularity <30% at the time of mobilization; age ≥65 years. This definition of proven and predicted PMs should be validated in clinical trials and common clinical practice.

MeSH terms

  • Aged
  • Antigens, CD34 / biosynthesis
  • Antineoplastic Agents / therapeutic use
  • Blood Component Removal
  • Clinical Trials as Topic
  • Granulocyte Colony-Stimulating Factor / metabolism
  • Hematopoietic Stem Cell Mobilization / methods*
  • Humans
  • Italy
  • Lymphoma / therapy*
  • Medical Oncology / methods
  • Multiple Myeloma / therapy*
  • Radiotherapy / methods
  • Surveys and Questionnaires
  • Time Factors

Substances

  • Antigens, CD34
  • Antineoplastic Agents
  • Granulocyte Colony-Stimulating Factor