Peripheral blood progenitor cell mobilization in patients with primary refractory lymphoma or at first relapse: Comparison with patients at diagnosis and impact on clinical outcome

C. Tarella, C. Castellino, C. Cherasco, P. Bondesan, F. Giaretta, P. Corradini, D. Caracciolo, P. Gavarotti, A. Pileri

Research output: Contribution to journalArticlepeer-review

Abstract

Peripheral blood progenitor cell (PBPC) mobilization was evaluated in 53 patients receiving the high-dose sequential (HDS) regimen: 27 had non- Hodgkin's lymphoma or Hodgkin's disease, primary refractory or at first relapse, 26 had non-Hodgkin's lymphoma at diagnosis. Mobilization was assessed following either 7 g/m2 cyclophosphamide (48 patients) or 2 g/m2 etoposide, both followed by G-CSF (filgrastim) at 5 μg/kg/d. PBPC mobilization was significantly higher in patients at diagnosis compared to refractory/relapsed patients (median peak values of circulating CFU-GM: 25 209/ml v 4270/ml, P <0.0001 and CD34+ cells: 286/μl v 47/μl, P <0.0001). All patients receiving HDS as up-front treatment mobilized enough PBPC for an autograft, often requiring a single leukapheresis; whereas only 15 patients under salvage treatment with FIDS were able to complete PBPC autograft. Bone marrow (BM) cells, alone or with PBPC, were needed in six patients, and autograft could not be performed in six patients. Among refractory/relapsed patients, those having a high PBPC mobilization experienced a significantly longer FFS compared to those who had not; autograft completion also significantly enhanced EFS. Thus, the use of an effective mobilizing protocol does not ensure adequate PBPC mobilization in moderately pretreated patients; low mobilization must be considered as an early sign of poor outcome in patients receiving a high-dose salvage programme.

Original languageEnglish
Pages (from-to)41-46
Number of pages6
JournalBritish Journal of Haematology
Volume99
Issue number1
Publication statusPublished - 1997

Keywords

  • Lymphoid malignancies
  • PBPC autograft
  • Progenitor mobilization
  • Salvage treatment

ASJC Scopus subject areas

  • Hematology

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