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Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Oct 24, 2017; 7(5): 250-259
Published online Oct 24, 2017. doi: 10.5500/wjt.v7.i5.250
Peripheral blood stem cell mobilization in multiple myeloma: Growth factors or chemotherapy?
Whitney D Wallis, Muzaffar H Qazilbash
Whitney D Wallis, Muzaffar H Qazilbash, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
Author contributions: Authors contributed equally to this work.
Conflict-of-interest statement: Authors have no relevant conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Muzaffar H Qazilbash, MD, the University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, United States. mqazilba@mdanderson.org
Telephone: +1-713-7922466 Fax: +1-713-7944902
Received: April 28, 2017
Peer-review started: April 28, 2017
First decision: June 16, 2017
Revised: August 25, 2017
Accepted: September 12, 2017
Article in press: September 13, 2017
Published online: October 24, 2017
Processing time: 178 Days and 6.3 Hours
Abstract

High-dose therapy followed by autologous hematopoietic stem cell (HSC) transplant is considered standard of care for eligible patients with multiple myeloma. The optimal collection strategy should be effective in procuring sufficient HSC while maintaining a low toxicity profile. Currently available mobilization strategies include growth factors alone, growth factors in combination with chemotherapy, or growth factors in combination with chemokine receptor antagonists; however, the optimal strategy has yet to be elucidated. Herein, we review the risks and benefits of each approach.

Keywords: Multiple myeloma; Stem cell; Mobilization; Growth factors; Chemotherapy

Core tip: Obtaining an adequate peripheral blood stem cell yield is essential for the successful outcome of autologous hematopoietic stem cell transplant in multiple myeloma. While growth factor mobilization continues to be largely successful, suboptimal collection rates have been noted, particularly as use of novel therapies continue to increase. Chemomobilization remains toxic and has not been associated with better disease control. The newest mobilizing agent, plerixafor, is capable of overcoming suboptimal mobilization even in patients who are at a high risk of mobilization failure. Each mobilization strategy should be selected based on patient specific variables as well as risk factors for mobilization failure.