TY - JOUR
T1 - Predictors of CD34+ cell mobilization and collection in adult men with germ cell tumors
T2 - Implications for the salvage treatment strategy
AU - Necchi, Andrea
AU - Miceli, Rosalba
AU - Pedrazzoli, Paolo
AU - Giannatempo, Patrizia
AU - Secondino, Simona
AU - Di Nicola, Massimo
AU - Farè, Elena
AU - Raggi, Daniele
AU - Magni, Michele
AU - Matteucci, Paola
AU - Longoni, Paolo
AU - Milanesi, Marco
AU - Paternò, Emanuela
AU - Ravagnani, Fernando
AU - Arienti, Flavio
AU - Nicolai, Nicola
AU - Salvioni, Roberto
AU - Carlo-Stella, Carmelo
AU - Gianni, Alessandro M.
PY - 2014
Y1 - 2014
N2 - Background High-dose chemotherapy with tandem or triple carboplatin and etoposide course is currently the first curative choice for relapsing GCT. The collection of an adequate amount of hematopoietic (CD34+) stem cells is a priority. Patients and Methods We analyzed data of patients who underwent HDCT at 2 referral institutions. Chemotherapy followed by myeloid growth factors was applied in all cases. Uni- and multivariable models were used to evaluate the association between 2 prespecified variables and mobilization parameters. Analyses included only the first mobilizing course of chemotherapy and mobilization failures. Results A total of 116 consecutive patients underwent a mobilization attempt from December 1995 to November 2012. Mobilizing regimens included cyclophosphamide (CTX) 7 gr/m2 (n = 39), cisplatin, etoposide, and ifosfamide (PEI) (n = 42), paclitaxel, cisplatin, and gemcitabine (TPG) (n = 11), and mixed regimens (n = 24). Thirty-seven percent were treated in first-line, 50% (n = 58) in second-line, 9.5% (n = 11) and 3.4% (n = 4) in third- and fourth-line settings, respectively. Six patients did not undergo HDCT because they were poor mobilizers, 2 in first- and second-line (1.9%), and 4 beyond the second-line (26.7%). In the multivariable model, third-line or later setting was associated with a lower CD34+ cell peak/μL (P =.028) and a lower total CD34+/kg collected (P =.008). The latter was also influenced by the type of mobilizing regimen (P + cell mobilization in the therapeutic algorithm of relapsing GCT, for whom multiple HDCT courses are still an option, and potentially a cure.
AB - Background High-dose chemotherapy with tandem or triple carboplatin and etoposide course is currently the first curative choice for relapsing GCT. The collection of an adequate amount of hematopoietic (CD34+) stem cells is a priority. Patients and Methods We analyzed data of patients who underwent HDCT at 2 referral institutions. Chemotherapy followed by myeloid growth factors was applied in all cases. Uni- and multivariable models were used to evaluate the association between 2 prespecified variables and mobilization parameters. Analyses included only the first mobilizing course of chemotherapy and mobilization failures. Results A total of 116 consecutive patients underwent a mobilization attempt from December 1995 to November 2012. Mobilizing regimens included cyclophosphamide (CTX) 7 gr/m2 (n = 39), cisplatin, etoposide, and ifosfamide (PEI) (n = 42), paclitaxel, cisplatin, and gemcitabine (TPG) (n = 11), and mixed regimens (n = 24). Thirty-seven percent were treated in first-line, 50% (n = 58) in second-line, 9.5% (n = 11) and 3.4% (n = 4) in third- and fourth-line settings, respectively. Six patients did not undergo HDCT because they were poor mobilizers, 2 in first- and second-line (1.9%), and 4 beyond the second-line (26.7%). In the multivariable model, third-line or later setting was associated with a lower CD34+ cell peak/μL (P =.028) and a lower total CD34+/kg collected (P =.008). The latter was also influenced by the type of mobilizing regimen (P + cell mobilization in the therapeutic algorithm of relapsing GCT, for whom multiple HDCT courses are still an option, and potentially a cure.
KW - Hematopoietic stem cell transplantation
KW - High-dose chemotherapy
KW - Male germ cell tumor
KW - Testicular neoplasms
UR - http://www.scopus.com/inward/record.url?scp=84900330735&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84900330735&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2013.11.021
DO - 10.1016/j.clgc.2013.11.021
M3 - Article
C2 - 24361054
AN - SCOPUS:84900330735
VL - 12
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
SN - 1558-7673
IS - 3
ER -