A BCNU-containing Regimen,Mini-BEAM,with GM-CSF is a Safe and Effective Mobilizing Regimen Pre-stem Cell Transplantation in Lymphoma Patients |
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| Authors: | Francis Joseph Giles Anna Jacobs Samuel H. Pepkowitz Marie Perrelli Fuerst Stephen Wong Lim |
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| Affiliation: | 1. Stem Cell/Bone Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, California, USA;2. Transfusion Medicine, Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA |
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| Abstract: | Concern has been raised regarding the quality and engraftment potential of peripheral stem cells obtained from mobilizing regimens containing BCNU. We compared the mononuclear cell (MNC) yields and engraftment times of neutrophils and platelets in twenty-nine patients who received autologous peripheral blood stem cell transplants at our institution. Sixteen patients with either refractory or resistant Hodgkin's disease or non-Hodgkin's lymphoma, were mobilized with a BCNU-containing regimen, mini-BEAM (BCNU 60 mg/m2 on day 1, etoposide 100 mg/m2 on days 1–3, cytarabine 150 mg/m2q12h on days 1–3, and melphalan 30 mg/m2 on day 3). Thirteen patients with various malignancies were mobilized with non-BCNU containing priming regimens. All patients received rhGM-CSF (Leukine, Immunex, Seattle, WA) 250μg/m2 subcutaneously daily from 24 hours after completion of mobilizing chemotherapy through the completion of leukapheresis. The mean mononuclear cell yields in the BCNU versus non-BCNU containing regimens were 2.15 and 1.97 × 108 MNC/kg [95% CI -.32 to.68] after a median of 3 and 3 leukaphereses respectively. The median time post-stem cell infusion to an absolute neutrophil count (ANC) of ≥0.5 × 109/1 were 11 days and 13 days [mean 11.7 and 12.2, p = 0.99, 95% CI -2.5, 1.6], days to an ANC of ≥1.0 x 109/1 were 13 and 13 [mean 13.8 and 13.1, p = 0.47, 95% CI-1.8, 3.3], days to a platelet count of ≥20 × 109/1 were 9 and 9 days [mean 11.4 and 9.8, p = 0.10, CI -0.6, 4.0], and days to a platelet count of ≥50 × 109/1 were 14 and 15 days (p = 0.14) respectively. Mini-BEAM, as a mobilizing regimen, is easily administered as an outpatient. Stem cells mobilized with this regimen produces similar mononuclear cell yields as compared to non-BCNU containing regimens. There was no difference in the engraftment times for ANC or platelets from stem cells mobilized with BCNU versus non-BCNU containing regimens. |
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| Keywords: | Hodgkin's disease non-Hodgkin's lymphoma stem cell transplantation mini-BEAM mobilizing |
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