Is neutropenic fever an obstacle to effective stem cell harvesting?
Asian Journal of Transfusion Science, cilt.18, sa.1, ss.21-26, 2024 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 1
- Basım Tarihi: 2024
- Doi Numarası: 10.4103/ajts.ajts_152_21
- Dergi Adı: Asian Journal of Transfusion Science
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
- Sayfa Sayıları: ss.21-26
- Anahtar Kelimeler: Autologous stem cell transplantation, chemomobilization, febrile neutropenia, neutropenic fever, stem cell mobilization
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
INTRODUCTION: Autologous stem cell transplantation (ASCT) is a well‑established consolidation treatment for many hematologic cancers which delivers prolonged survival. A subset of patients’ adequate stem cell harvest is not achievable with a solitary use of granulocyte colony‑stimulating agents (G‑CSF). Generally, chemomobilization is employed for patients failing G‑CSF and its most feared complication febrile neutropenia (FN). MATERIALS AND METHODS: Here, we aimed to investigate the impact of the FN in chemomobilization on apheresis outcomes and engraftment. One hundred and eighty‑three patients with the diagnosis of lymphoma or myeloma who underwent chemomobilization between 2015 and 2020 were included in the study. RESULTS: Forty‑three patients experienced FN. All patients received G‑CSF. All myeloma patients were mobilized with 4 g/m2 cyclophosphamide, but it was heterogeneous for lymphoma patients. The precollection blood counts, harvested CD34+ hematopoietic stem cells (HSCs)/kg, apheresis count, and engraftment durations were recorded. Preapheresis leukocyte and platelet were lower in the FN group (P = 0,004 and P = 0,001). Peripheral CD34 HSCs and total harvested CD34 HSCs were similar among groups (P = 0.25 and P = 0.9). More apheresis was needed in the FN group, but it was not significant (P = 0.07). Undergoing ASCT was similar (P = 0.7); however, platelet and neutrophil engraftment durations were slower in the FN group (P = 0.05 and P = 0.001). CONCLUSION: Harvesting sufficient CD34+ HSCs from patients with FN is still feasible; however, FN treatment should begin promptly, and further apheresis sessions may be required.