Febrile neutropenia adversely affects chemomobilization outcomes in patients with multiple myeloma and increases risk for post-transplant infection in those with lymphoma: real-world multicenter data

The precise impact of febrile neutropenia (FN) during chemomobilization on the collection of CD34 ⁺ peripheral blood stem cells and post-transplant infection(s) in patients with multiple myeloma (MM) and lymphoma undergoing autologous stem cell transplantation (ASCT) remains insufficiently characterized. Real-world records of 148 patients diagnosed with MM and 130 with lymphoma, who underwent ASCT between October 2010 and January 2024, were retrospectively analyzed. All patients underwent chemotherapy with granulocyte colony-stimulating factors (G-CSF) for stem cell mobilization. Statistical analysis was performed using GraphPad Prism 9 ( p < 0.050). FN was associated with poorer estimated 5-year overall survival in patients with MM (61.0% vs 84.4%; p = 0.002). Patients with MM and FN required greater G-CSF stimulation ( p < .001), longer apheresis ( p = 0.007), and had lower CD34 ⁺ cell yield ( p < .001). They also exhibited lower optimal-mobilization rates ( p < .001), and delayed neutrophil ( p = 0.006) and platelet ( p = 0.028) engraftment. In patients with lymphoma, FN was associated with prolonged apheresis ( p = .001), delayed platelet engraftment ( p = 0.017), and an increased risk for pre-engraftment infection ( p = 0.034). FN during chemomobilization was associated with worse long-term survival and impaired stem cell mobilization in patients with MM, along with a heightened risk for pre-engraftment infection(s) in those with lymphoma.