Objective: Chronic graft versus host disease (cGVHD) develops after allogeneic hematopoietic cell transplantation, when immune cells from a non-identical donor initiate an immune reaction against the transplant recipient. Extracorporeal photopheresis (ECP) can be used in combination with prednisone in steroid-resistant cGVHD. In this study, the effect of ECP use on survival in cGVHD was examined. Patients and Methods: Twenty-six patients who were followed up in the adult Hematology Clinic of Inonu University Turgut Ozal Medical Center for cGVHD were included in the study. Stem cell transplantation and ECP application parameters that may affect the survival of the patients were examined. Results: The degree of involvement in cGVHD affects survival. Involvements with clinical and laboratory scores of 2 and above according to the National Institutes of Health consensus criteria, significantly reduced survival. The development time of cGVHD was found to be associated with survival, and that it had a positive impact on survival, especially when the disease developed after 220 days after the transplantation. It was observed that steroid dose taken during ECP, patient age and cGVHD prophylaxis used affected survival. Conclusion: The use of ECP may be effective in survival, especially, in patients who develop cGVHD, 220 days after allogeneic transplantation. Concurrent use of steroids with ECP affects survival.
Objective: The aim of this study is to investigate the effect of the preemptive use of plerixafor in patients with lymphoma and multiple myeloma which was administered as a preemptive single dose to the patients who were determined to have a CD34+ cell count of <15/ μL in the peripheral blood (PB) on the 4th day of mobilization. Patients and Methods: Thirty-five patients who were administered plerixafor on the 4th day after granulocyte colony-stimulating factor (G-CSF) alone for stem cell mobilization between January 2020 and November 2021 were included. CD34+ stem cell counts in PB before and after plerixafor, the amount of CD34+ stem cells collected, and the outcome of transplantation was examined. Results: The median CD34+ cell count in PB on the 4th day was 5.2/μL (0.1-13.4), which was determined to increase 206.6-fold (31.57- 49347) to 924.80 /μL (295.00-5056) following the administration of plerixafor on the 5th day (Z=-5.160; r= – 872.2; p<0.0001). The number of apheresis sessions was 1 in all patients. The median collected CD34+ cell count was 5.90x106/kg (2.70x106-14.4x106). Conclusion: The use of preemptive plerixafor shows that it is an effective mobilization method by increasing the rate of stem cell collection at an effective dose and reducing the mobilization time/apheresis sessions.