Is mobilization failure predictable before autologous stem cell transplantation in patients with malign lymphoma? the role of cxcr4 and vla-4 antigen presentation on the cd34 positive stem cell in the bone marrow and serum iron load, inflamatory cytokines and soluble adhesion molecules level in mobilization.

High dose chemotherapy/autologous stem cell transplantation (HDC/ASCT) is considered to be the standard treatment strategy for patients with relapsed/refractory Hodgkin (HL) and non Hodgkin lymphoma (NHL). Mobilization failure is an important handicap which is observed in 5-30 % of these patients. Several risk factors including age, primary diagnosis, bone marrow involvement, extensive radiotherapy, hypocellular bone marrow, thrombocytopenia, hyperferritinemia and prior treatment with lenalidomide, melphalan and fludarabine were defined for mobilization failure. Besides adhesion molecules including SDF-1 and CXCR4, VCAM-1 and VLA-4, cytokines and chemokines were indicated to have a role in CD34+ mobilization. In the present study, we aimed to assess the impact of several adhesion molecules and cytokines on mobilization failure. A total of 38 HL and 45 NHL patients who received mobilization regimen for ASCT in Gazi University Stem Cell Transplantation Unit were included. Median age was 29,5 (17-65) and 51 (17-67) years, for HL and NHL patients, respectively. Patients were divided into three groups based on mobilization status: successful mobilization, poor mobilization and mobilization failure. Although CD34/CXCR4 and CD34/VLA-4 staining intensity were similar among the three groups, number of patients who had CD34/CXCR4 staining intensity ?2 were higher in the successful mobilization group. In terms of cytokine levels, only TGF-ß level was higher in the successful mobilized patients compared to poor mobilized patients. Further and larger studies are necessary to identify the risk factors for mobilization failure in order to modify mobilization strategies for better outcomes.