Mini-ICE effectively mobilises peripheral blood stem cells after fludarabine-based regimens in acute myeloid leukaemia
| Autor: | Giovanni Sparaventi, Giuliana Leopardi, Stefania Stramigioli, Alessandro Isidori, Pier Paolo Piccaluga, Barbara Guiducci, Francesca D'Adamo, Michele Malagola, Sara Barulli, Patrizia Politi, Nadia Talevi, Anna Mele, Lara Malerba, Giuseppe Visani, Giuseppina Nicolini |
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| Přispěvatelé: | Mele A, Leopardi G, Sparaventi G, Nicolini G, D'Adamo F, Guiducci B, Barulli S, Malerba L, Stramigioli S, Talevi N, Politi P, Isidori A, Malagola M, Piccaluga P, Visani G. |
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Transplantation Autologous Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Idarubicin Leukapheresis Etoposide Multiple myeloma Peripheral Blood Stem Cell Transplantation business.industry Cytarabine Hematology General Medicine Middle Aged medicine.disease Hematopoietic Stem Cell Mobilization Fludarabine Peripheral stem cell transplantation Thalidomide Leukemia Myeloid Acute Regimen Immunology Female business Vidarabine medicine.drug |
| Popis: | Fludarabine-based cycles severely impair mobilisation and collection of peripheral blood stem cells (PBSC) in acute myeloid leukaemia (AML). In an effort of reversing this side-effect, we studied the action on mobilisation and collection of PBSC of a low-dose regimen: 5-d Mini-ICE (oral idarubicin and etoposide; subcutaneous cytosine arabinoside) administered after fludarabine-based regimens in seven adult AML patients. Leukapheresis were started when the CD34+ cell count was more than 10/microL. The median number of harvested CD34+ cells was 8.1 x 10(6)/kg (range 3.08-15.2). All the patients were successfully submitted to PBSC transplantation. Median times to neutrophil and platelet recovery were rapid with a normal transfusional support. We suggest that the Mini-ICE programme is feasible, well tolerated and effective in terms of PBSC mobilisation and collection in low-yield AML patients previously treated with fludarabine. It is well known that a negative effect on stem cell mobilisation and harvest is observed not only after fludarabine administration in AML or low-grade lymphomas, but also after cycles based on different agents, such as thalidomide in multiple myeloma. This preliminary experience, if confirmed on larger series and/or other haematological malignancies, could open new opportunities to perform autologous PBSC transplantation in heavily pretreated cases, allowing a full source of therapeutic options before the start of the mobilisation process. |
| Databáze: | OpenAIRE |
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