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Collection of peripheral blood stem cells

Collection of peripheral blood stem cells. Dr Kacem Karima Department of clinical haematology -HAO CMH - 26/05/2012. High-dose chemotherapy with peripheral blood stem cell support: best option for a high risk group of patients

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Collection of peripheral blood stem cells

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  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. Nb of patients : 94Nb of mobilizations : 104Criterion for adequate mobilization: at least 2.0 x 106 CD34+ cells/kg of patient.Leukapheresis: Nb CD34+(PB)≥ 20/mm3

  7. 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.

  8. Correlationbetween dose G-CSF and Nb CD34 collected

  9. 1st PBSC COLLECTION

  10. Provenpoormobilizer (GITMO) Peak CD34+ circulating cell count < 20/μl with lessthan 2 106harvested CD34+ cells/kg

  11. Predictedpoormobilizer (GITMO): at least one major criterion or twominorcriteria: Major criteria: • Failedprevious mobilisation • Prior extensive therapy • Previoustherapy: fluda, melphalan Minorcriteria • At least 2 priorcytotoxiclines • Refractory disease • Extensive BM involvement at mobilisation • Age > 65 years • BM cellularity < 30% at mobilisation

  12. Failures: 5 in studyperiod 5 betweenJanuary and May 2012 /13 pts

  13. 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

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