Factors associated with successful mobilization of peripheral blood progenitor cells in 200 patients with lymphoid malignancies |
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Authors: | Nicolas Ketterer Gilles Salles Isabelle Moullet Charles Dumontet Assia Eljaafari-Corbin Pierre Tremisi Catherine Thieblemont Brigitte Durand Eve-Marie Neidhardt-Berard Hanadi Samaha Dominique Rigal & Bertrand Coiffier |
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Institution: | Service d'Hématologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon and UPRES-JE 1879 'Hémopathies Lymphoïdes Malignes', UniversitéClaude Bernard, Pierre-Bénite; Etablissement de Transfusion Sanguine de Lyon, Lyon, France |
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Abstract: | Peripheral blood progenitor cells (PBPC) were mobilized and harvested in 200 patients treated for non-Hodgkin's lymphoma ( n = 148), Hodgkin's disease ( n = 22) and multiple myeloma ( n = 30). The variables predicting the collection of a minimal (>2.5 × 106/kg) or a high (>10 × 106/kg) CD34+ cell count were analysed. Patients were mobilized with haemopoietic growth factors following either standard chemotherapy ( n = 49) or high-dose cyclophosphamide, given alone ( n = 55) or combined with high-dose VP16 ( n = 86). 10 patients received haemopoietic growth factors only. The first mobilization resulted in a PBPC harvest with enough CD34+ cells in 179/200 patients (90%). High-dose cyclophosphamide, with or without VP16, did not mobilize a higher progenitor cell yield than standard chemotherapy. When performing multiple regression analysis in the 190 patients who received chemotherapy-containing mobilization, only the number of previous chemotherapy regimens and the exposure to fludarabine predicted for a failure to collect a minimal PBPC count ( P = 0.06 and 0.0008 respectively). The target to collect a high CD34+ cell count was negatively associated with the number of previous chemotherapy regimens ( P = 0.002). When only non-Hodgkin's lymphoma patients were considered for multivariate analysis, low-grade histology with fludarabine appeared to be associated with poor PBPC cell yield ( P = 0.08 and 0.005 respectively). This data confirms that PBPC harvest should be planned early in the disease course in transplant candidates, and can be obtained after a standard course of chemotherapy. |
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Keywords: | Keywords: peripheral blood progenitor cell mobilization CD34+ cells lymphoma |
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