EBMT 2017 | Advances in autologous treatment and mobilization in lymphoma
Anna Sureda, MD, PhD, from the Catalan Institute of Oncology, Duran I Reynals Hospital, Barcelona, Spain, discusses autologous stem cell transplantation and stem cell mobilization in lymphoma patients at the 2017 annual meeting of the European Society for Blood and Marrow Transplantation (EBMT) in Marseille, France. She highlights that it is important to recognize that lymphomas are the second indication for autologous stem cell transplantation, despite the advent of new drugs or targeted therapy. For diffuse large B-cell lymphoma, follicular lymphoma, and Hodgkin lymphoma, patients receiving transplants are those who have failed first-line chemotherapy and are in chemosensitive disease. In her talk, she also discussed mobilization strategies to collect peripheral blood stem cells in patients who are candidates for an autologous stem cell transplant, and she points out that even in 2017, mobilization failure constitutes a great problem in lymphoma patients, and is seen in 10 – 20% of patients. This issue has been addressed in several prospective clinical trials. Dr Sureda explains that plerixafor, which has been used for many years in clinical practice, is able to increase CD34+ cells in the peripheral blood when combined with G-CSF. According to Dr Sureda, what needs to be discussed in the lymphoma field is the mobilization of peripheral stem cells using chemotherapy with G-CSF with plerixafor, or if G-CSF based strategies should be used. She highlights that both strategies have pros and cons, but points out that the majority of physicians attending the symposium she held stated that they used a combination of chemotherapy with G-CSF to mobilize stem cells into the peripheral blood in lymphoma patients, as the chemotherapy is being used at the same time to treat the underlying malignancy.
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