The role of heparin in autologous stem cell mobilization in patients with multiple myeloma

Background: Autologous hematopoietic stem cell transplantation (aHSCT) has become the standard treatment modality for eligible multiple myeloma (MM) patients. One of the most important parameters affecting the success of transplantation is the number of CD34⁺ stem cells collected. The most commonly used agents to facilitate the release of CD34⁺ stem cells into peripheral blood are granulocyte colony-stimulating factor and plerixafor. Heparin has also been shown to enhance the release of CD34⁺ stem cells into peripheral blood. We aimed to report the effect of heparin on the number of CD34⁺ stem cells in peripheral blood in MM patients who underwent aHSCT. Materials and methods: This multicenter retrospective study analyzed 138 adult patients diagnosed with MM who underwent aHSCT. Patients were divided into two groups: those who received heparin (n = 108) and those who did not receive heparin before aHSCT (n = 30). Results: The complete response, partial response, and very good partial response rates in the heparin group were 17 % (n = 18), 24 % (n = 26), and 59 % (n = 64), respectively. In the non-heparin group, 20 % of patients (n = 6) achieved complete response, while partial response and very good partial response rates were 33 % (n = 10) and 47 % (n = 14), respectively. There was no statistically significant difference between the groups regarding obesity, ECOG performance scores, and smoking status (p = 0.399, 0.578, and 0.602, respectively). The number of collected CD34⁺ stem cells and the peak CD34⁺ stem cell count in peripheral blood were significantly higher in the heparin group compared to the control group (both p < 0.001). Conclusion: Heparin has been shown to enhance the migration of CD34⁺ stem cells into peripheral blood and facilitate the peripheral stem cell collection process.