Efficacy and safety of stem cell mobilization following gemcitabine, dexamethasone, cisplatin (GDP) salvage chemotherapy in patients with relapsed or refractory lymphoma

Leuk Lymphoma. 2020 Sep;61(9):2153-2160. doi: 10.1080/10428194.2020.1762882. Epub 2020 Jun 1.

Abstract

High-dose chemotherapy and autologous stem cell transplant (ASCT) remains a cornerstone of treatment in relapsed/refractory (R/R) aggressive-histology lymphomas. This retrospective study examined efficacy and safety of peripheral blood stem cell (PBSC) mobilization using cyclophosphamide/etoposide and GCSF (CE + GCSF, n = 129) versus gemcitabine, dexamethasone and cisplatin and GCSF (GDP + GCSF, n = 210). All patients received first salvage with GDP. Patients mobilized with CE + GCSF required fewer days of leukapheresis (median 1 vs 2 day; p = .001) and achieved higher total CD34+ yield than GDP + GCSF patients (8.5 vs 7.1 × 106 CD34+ cells/kg, p = .001). Rates of febrile neutropenia and CD34+ collection ≥5 × 106 CD34+ cells/kg were similar (OR 1.19, 95% CI: 0.54-2.6, p = .66). In multivariable analysis, days to engraftment and admission duration were not statistically different between the two mobilization strategies. While CE + GCSF appeared more efficacious for mobilization after GDP salvage, this did not translate to significant differences in clinical outcomes.

Keywords: Autologous stem cell transplant; lymphoma; salvage chemotherapy; stem cell mobilization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Cisplatin / therapeutic use
  • Deoxycytidine / analogs & derivatives
  • Dexamethasone / therapeutic use
  • Etoposide / therapeutic use
  • Gemcitabine
  • Hematopoietic Stem Cell Mobilization
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Lymphoma* / drug therapy
  • Retrospective Studies
  • Salvage Therapy

Substances

  • Deoxycytidine
  • Etoposide
  • Dexamethasone
  • Cisplatin
  • Gemcitabine