Risk factors and incidence of mobilization failure in autologous stem cell transplant: 10 years’ experience in a specialized bone marrow transplant center, Baghdad Medical City

BACKGROUND: Successful hematopoietic stem cell mobilization is essential for hematopoietic cell transplantation. However, mobilization failure remains a clinical challenge, particularly in settings with limited access to plerixafor. Understanding its predictors is crucial to improving transplant outcomes in Iraq. OBJECTIVES: The aims of this study were to determine the incidence and predictors of stem cell mobilization failure in the Hematology and Transplant Center in Baghdad Medical City. MATERIALS AND METHODS: This retrospective study was conducted at the HBMT Center, Baghdad Medical City, and included 395 adult and pediatric patients with various hematologic malignancies who underwent stem cell mobilization between January 2013 and December 2023. Clinical, disease, and treatment-related factors were analyzed in relation to mobilization outcomes. RESULTS: Mobilization failure occurred in 11.6% (46/395) of patients. Failure was significantly associated with bone marrow involvement and prior chemotherapy exposure, whereas diagnosis also influenced outcome – being most frequent among multiple myeloma patients. The mean age was 42.1 years, and the mean BMI was 27.4 kg/m 2 . Use of Plerixafor was rare during the study period. CONCLUSION: Despite limited drug availability, the mobilization failure rate in our center was comparable to international data. Expanding access to c and optimizing mobilization protocols could enhance stem cell collection efficiency and reduce hospitalization days in Iraq.