%0 Journal Article
%T Plerixafor-based mobilization in pediatric healthy donors with unfavorable donor/recipient body weight ratio resulted in a better CD34+ collection yield: A retrospective analysis.
%A Zubicaray J
%A Galvez E
%A Sebastian E
%A Molina B
%A González-Vicent M
%A Castillo A
%A Ramírez M
%A Madero L
%A Díaz MA
%A Sevilla J
%J J Clin Apher
%V 36
%N 1
%D Feb 2021
%M 33079424
%F 2.605
%R 10.1002/jca.21844
%X <B>BACKGROUND: </B>In order to propose risk-adapted mobilization algorithms, several authors have tried to look for predictive factors of the CD34+ yield in healthy pediatric donors. Donor recipient body weight ratio (D/R ratio) was identified as one of the main variables related with the success to achieve the target cell dose for transplantation. According to this variable we modified the mobilization schedule.<BR><B>METHODS: </B>We report the results of 46 mobilizations and apheresis procedures performed in our center with unfavorable D/R ratio. Mobilization was attempted by the standard regime of G-CSF (10 mcg/kg/24 hours) in 28 cases (60.9%), with high dose G-CSF (10 mcg/kg/12 hours) in 9 cases (19.6%), and with plerixafor and G-CSF single dose regime in 9 cases (19.6%).<BR><B>RESULTS: </B>CD34+ cell quantification before apheresis is closely related to CD34+ yield, being the only factor related to collected CD34+ cells (beta .71; P < .0001). The mobilization efficiency was higher in plerixafor group compared to the other two schedules (P < .0001). By using plerixafor for mobilization, we achieved the target CD34+ cell dose of ≥2 × 106 /kg per recipient body weight in all cases with unfavorable D/R ratio. It was observed that 17.4% of cases that not reached the established target cell dose were located in the standard or high-dose mobilization regimes. This difference is even greater for optimal collections (≥5 × 106 /kg), since of the 54.3% cases that did not reach this goal none was mobilized by plerixafor.<BR><B>CONCLUSIONS: </B>Tailoring the mobilization regime we can reach the target cell dose, even in those cases with the worst D/R ratio.