Factors associated with successful mobilization of peripheral blood progenitor cells in 200 patients with lymphoid malignancies.

Autor: Ketterer, Nicolas, Salles, Gilles, Moullet, Isabelle, Dumontet, Charles, Eljaafari-Corbin, Assia, Tremisi, Pierre, Thieblemont, Catherine, Durand, Brigitte, Neidhardt-Berard, Eve-Marie, Samaha, Hanadi, Rigal, Dominique, Coiffier, Bertrand
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Zdroj: British Journal of Haematology; Oct98, Vol. 103 Issue 1, p235-241, 8p
Abstrakt: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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