DOES BMI/BSA AFFECT STEM CELL MOBILISATION?: SINGLE CENTRE EXPERIENCE
Objective: Haematopoietic stem cell transplantation is accepted as an important treatment strategy in the treatment of many haematological diseases including acute leukaemia, lymphoma, multiple myeloma as well as sickle cell anaemia and beta thalassaemia major. BMI is an important factor affecting t...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
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| Series: | Hematology, Transfusion and Cell Therapy |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137924028955 |
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| Summary: | Objective: Haematopoietic stem cell transplantation is accepted as an important treatment strategy in the treatment of many haematological diseases including acute leukaemia, lymphoma, multiple myeloma as well as sickle cell anaemia and beta thalassaemia major. BMI is an important factor affecting the donor's response to mobilisation and thus haematopoietic progenitor cell yield. This effect is thought to be due to the relatively high dose of filgrastim administered to donors with higher BMI or to the presence of unknown intrinsic factors affecting mobilisation related to the amount of adipose tissue in each donor. In studies examining the relationship between obesity and CD34, negative effects of BMI on the number of progenitor cells have been shown. Methodology: A total of 41 patients, including 32 patients and 9 healthy donors, who underwent stem cell mobilisation for bone marrow transplantation in the therapeutic apheresis unit of Konya City Hospital between 10/2023 and 8/2024 were included in our study. The effects of disease diagnosis, age, number and content of chemotherapy, radiotherapy history, body surface area (BSA), body mass index (BMI), chronic habits such as smoking and alcohol, comorbidity and vitamin D level on stem cell mobilisation were investigated. Results: In our study, data of 9 healthy donors, 21 multiple myeloma and 11 lymphoma patients were analysed. Median age was 61 (18-72) years, 46.3% (19) were female and 53.7% (22) were male. There was a history of radiotherapy in 9.8% of the patients. While 46.3% of the patients were mobilised with cyclophosphamide+filgrastim, 41.5% with filgrastim, 4.9% with other chemotherapeutic agents+ filgrastim, 4.9% with filgrastim+plerixafor, 2.4% of the patients had stem cell collection by harvest procedure. On day 1 of stem cell mobilisation, there was no difference between those who collected sufficient CD34 positive stem cells and those who failed in terms of gender, height, weight, BMI, BSA, chronic habits, presence of comorbidities, vitamin D level and number of chemotherapy received. There was no statistically significant correlation between the total amount of CD34 positive stem cells and gender, height, weight, BMI, BSA, chronic habits, presence of comorbidities, vitamin D level and number of received chemotherapy. A negative, strong and statistically significant correlation was found between the number of CD34 positive stem cells and BMI in multiple myeloma patients (rho: -0.705 p<0.001). Conclusion: Hematopoietic stem cell transplantation used in the treatment of many haematological disorders has become the gold standard treatment. Therefore, the factors affecting the success of transplantation have been the subject of research, and the effects of factors such as BMI, vitamin D, and gender have been investigated. In a cohort of 149 volunteers participating in a weight loss programme, the absolute number of CD34 positive progenitor cells and VEGF receptor-2, CD133 and CD117 positive cell subtypes decreased in relation with increasing BMI and waist circumference. Weight loss caused an increase in CD34 and CD117/CD34 cell counts. In our study, it was shown that high BMI in multiple myeloma patients caused lower CD34 levels in the cell collection process. We believe that it would be useful to perform this analysis with a larger patient population. |
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| ISSN: | 2531-1379 |