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

Br J Haematol. 1998 Oct;103(1):235-42. doi: 10.1046/j.1365-2141.1998.00960.x.

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 x 10(6)/kg) or a high (>10 x 10(6)/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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD34 / metabolism
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cytokines / therapeutic use*
  • Female
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cells / metabolism
  • Hodgkin Disease / therapy*
  • Humans
  • Leukapheresis
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Middle Aged
  • Multiple Myeloma / therapy*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antigens, CD34
  • Cytokines