Progress in mobilization of autologous hematopoietic stem cell transplantation in treatment of multiple myeloma

Several factors influence mobilization outcomes, including older age and disease state. The type of prior chemotherapy (melphalan), a higher number of prior treatment lines, prior irradiation or the CD34+ cell count in peripheral blood before apheresis was applied. Common mobilization regimens consist of monotherapy with G-CSF and chemotherapy +G-CSF. The HSC mobilization effect is enhanced in chemotherapy +G-CSF compared with G-CSF alone, while its incidence and severity of side effects are increased at the same time. The appropriate mobilization regimen is based on patients' disease state and physical condition. Plerixafor, a novel agent, can be used to enhance the HSC mobilization effect of G-CSF, especially in poor mobilizers after chemomobilization. Other novel regimens are currently being evaluated in different trials. Key words: Multiple myeloma; Autologous hematopoietic stem cell transplantation; Mobilization