Fludarabine-containing regimens severely impair peripheral blood stem cells mobilization and collection in acute myeloid leukaemia patients

Giuseppe Visani, R. M. Lemoli, P. Tosi, G. Martinelli, N. Testoni, P. Ricci, P. P. Piccaluga, R. Pastano, G. Leopardi, A. Dizdari, M. R. Motta, S. Rizzi, S. Tura

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We studied the effects of an intensified induction/consolidation treatment containing fludarabine (ICE/FLAN/FLAN) on the mobilization and collection of peripheral blood stem cells (PBSC) in 31 consecutive untreated acute myeloid leukaemia (AML) patients. The complete remission (CR) rate was comparable to classic inductions (68% after ICE; 84% after ICE-FLAN I). To mobilize PBSC, 19 patients received 10 μg/kg/d of granulocyte-colony stimulating factor (G-CSF) starting at day 13 after FLAN. 13 (69%) of whom were found to be nonmobitizers. When a second G-CSF administration was performed in 10/13 patients mobilization was either not achieved (8/10) or was considered insufficient (6 CD34+ cells/kg) (2/10) and all 13 were subsequently submitted to bone marrow harvest. The harvest was considered adequate in 12/13 (92%) patients and autologous BMT (ABMT) has so far been performed in 10/12 cases with a mean of 8.6 x 108/kg nucleated reinfused cells. The median times to neutrophil and platelet recovery after ABMT did not significantly differ from those of two previous series of patients treated with ABMT without fludarabine-containing regimens. Adequate amounts of PBSC were obtained in 6/19 (31%) patients, who were then reinfused. Median times for platelet recovery were significantly longer than in a previous series of 26 AML cases reinfused with PBSC after treatment with the ICE-NOVIA induction/consolidation regimen (125 v 20 d to 20x109 plt/l. P<0.02; 218 v 37 d to 50x109 plt/l, P

Original languageEnglish
Pages (from-to)775-779
Number of pages5
JournalBritish Journal of Haematology
Issue number3
Publication statusPublished - 1999


  • Autologous transplantation
  • Fludarabine
  • Myeloid leukaemia
  • Stem cells

ASJC Scopus subject areas

  • Hematology


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