Pre-test for Optimal Use of Autologous Transplantation and Stem Cell Mobilization in Patients with Multiple Myeloma and Non-Hodgkin’s Lymphoma Name* First Last Email* The minimal “dose” of CD34+/kg recommended for safe autologous transplantation is:* 1 x 1066 2 x 1066 4 x 106 6 x 106 In NHL, a proven benefit of autologous transplant with a higher CD34+ dose is:* Faster platelet engraftment Better survival Lower risk of relapse Less mucositis The following is not a risk factor for poor CD34+ mobilization:* Being a smoker Being female Platelets <100,000/mm3 prior to mobilization Being older In regards to prior use of lenalidomide and mobilization of autologous CD34+ cells it is correct to state:* Prior Lenalidomide has no effect on mobilization Patients who received >4 cycles of lenalidomide can only be effectively mobilized with chemotherapy Patients with myeloma who are considered transplant eligible should not receive lenalidomide as part of induction therapy to prevent mobilization failure Extent of prior lenalidomide therapy negatively influence CD34+ mobilization so patients should preferentially undergo mobilization after no more than 4 cycles of lenalidomide. Regarding chemotherapy mobilization in myeloma:* High dose cyclophosphamide simultaneously mobilizes CD34+ cells and contributes to myeloma disease control. Is necessary in patients who received > 4 cycles of lenalidomide. Yields products with high CD34+ content, but carries more toxicity than other methods of mobilization. Cyclophosphamide has been proven to be superior to etoposide and cytarabine as mobilizing agent. The following is a caveat of mobilization utilizing filgrastrim plus plerixafor:* Collection yields lower than obtained with chemotherapy mobilization. Higher cost compared to filgrastrim alone. Higher cost compared to chemotherapy mobilization. Less predictable than chemotherapy mobilization
