Impact of Bone Marrow Involvement on the Success of Hematopoietic Stem Cell Mobilization in Patients With Lymphoma

ABSTRACT

The influence of bone marrow (BM) involvement at diagnosis on hematopoietic stem cell (HSC) mobilization outcomes remains to be fully elucidated, particularly in the contemporary plerixafor era. To address this issue, this multicenter retrospective cohort study including four lymphoma treatment centers evaluated patients who underwent their first autologous HSC mobilization procedure between January 2017 and June 2023. Mobilization success was defined as achieving a minimum CD34+ cell yield ≥ 2.0 × 10 ⁶ cells/kg. Propensity score matching (PSM) was performed to rigorously adjust for baseline confounders and ensure robust group comparisons. The study cohort comprised 669 patients, of whom 138 (20.6%) presented with BM involvement at the time of diagnosis. Analyzes revealed that mobilization success rates were highly comparable between patients with and without BM involvement, both before (79.0% versus [vs.] 81.2%; p  = 0.563) and after (79.1% vs. 83.5%; p  = 0.500) PSM. Furthermore, the median CD34+ cell yield did not differ significantly between the 2 cohorts either before (3.2 vs. 3.7 × 10 ⁶ /kg; p  = 0.192) or after (3.2 vs. 3.5 × 10 ⁶ /kg; p  = 0.639) PSM. These findings indicate that initial BM involvement does not significantly impair the success of HSC mobilization in patients with lymphoma, a conclusion that remained highly consistent even after controlling for baseline variables.