TY - JOUR
T1 - Standard-versus high-dose lenograstim in adults with hematologic malignancies for peripheral blood progenitor cell mobilization
AU - Romeo, Azzurra
AU - Chierichini, Anna
AU - Spagnoli, Alessandra
AU - Vittori, Mariangela
AU - Vacca, Michele
AU - Gozzer, Maria
AU - Spadea, Antonio
AU - Anaclerico, Barbara
AU - Dessanti, Maria Laura
AU - D'Andrea, Mariella
AU - Toglia, Giuseppe
AU - Annino, Luciana
AU - Petti, Maria Concetta
AU - Mengarelli, Andrea
AU - Arcese, William
PY - 2010/11
Y1 - 2010/11
N2 - Background: The aim of this retrospective, multicenter study was to compare high-versus standard-dose lenograstim after chemotherapy in collecting target dose of CD34+ peripheral blood progenitor cells (PBPCs) in adult candidates for autologous transplant. STUDY DESIGN AND METHODS: A total of 166 consecutive patients (28 acute leukemias [ALs], 77 lymphomas, 61 multiple myeloma [MM]) underwent 182 mobilization procedures. Only the first were analyzed. The CD34+ cell target was at least 2 × 106, 4 × 106, and 8 × 106/kg and lenograstim started on days +19, +1, and +5 from the end of chemotherapy for AL, lymphomas, and MM, respectively. Eighty-seven and 79 patients, respectively, received 5 and 10 μg/kg/day lenograstim subcutaneously (sc). An analysis to evaluate factors predicting satisfactory procedures and outcome of transplants performed with first-mobilization-procedure PBPCs was conducted. Most patients received 6 mg of pegfilgrastim or 5 μg/kg/day lenograstim sc after transplant. RESULTS: In multivariate analysis, high-dose lenograstim (p = 0.053) in MM and male sex (p = 0.028) were positive predictive factors for reaching cell target. Fludarabine negatively influenced stimulation length (p = 0.002). Apheresis, CD34+ cells mobilized and collected, blood volume processed, side effects, transplants performed, and engraftment time were similar between lenograstim cohorts. Pegfilgrastim versus lenograstim delayed platelet (PLT) recovery times (13 days vs. 11 days, p = 0.036). CONCLUSIONS: High-dose lenograstim more efficiently mobilized MM patients requiring the highest PBPC target but did not influence transplants performed and engraftment time. Male patients mobilized more efficiently. Fludarabine negatively influenced stimulation length. Finally, pegfilgrastim seems to delay PLT recovery.
AB - Background: The aim of this retrospective, multicenter study was to compare high-versus standard-dose lenograstim after chemotherapy in collecting target dose of CD34+ peripheral blood progenitor cells (PBPCs) in adult candidates for autologous transplant. STUDY DESIGN AND METHODS: A total of 166 consecutive patients (28 acute leukemias [ALs], 77 lymphomas, 61 multiple myeloma [MM]) underwent 182 mobilization procedures. Only the first were analyzed. The CD34+ cell target was at least 2 × 106, 4 × 106, and 8 × 106/kg and lenograstim started on days +19, +1, and +5 from the end of chemotherapy for AL, lymphomas, and MM, respectively. Eighty-seven and 79 patients, respectively, received 5 and 10 μg/kg/day lenograstim subcutaneously (sc). An analysis to evaluate factors predicting satisfactory procedures and outcome of transplants performed with first-mobilization-procedure PBPCs was conducted. Most patients received 6 mg of pegfilgrastim or 5 μg/kg/day lenograstim sc after transplant. RESULTS: In multivariate analysis, high-dose lenograstim (p = 0.053) in MM and male sex (p = 0.028) were positive predictive factors for reaching cell target. Fludarabine negatively influenced stimulation length (p = 0.002). Apheresis, CD34+ cells mobilized and collected, blood volume processed, side effects, transplants performed, and engraftment time were similar between lenograstim cohorts. Pegfilgrastim versus lenograstim delayed platelet (PLT) recovery times (13 days vs. 11 days, p = 0.036). CONCLUSIONS: High-dose lenograstim more efficiently mobilized MM patients requiring the highest PBPC target but did not influence transplants performed and engraftment time. Male patients mobilized more efficiently. Fludarabine negatively influenced stimulation length. Finally, pegfilgrastim seems to delay PLT recovery.
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U2 - 10.1111/j.1537-2995.2010.02723.x
DO - 10.1111/j.1537-2995.2010.02723.x
M3 - Article
C2 - 20553434
AN - SCOPUS:78349239202
VL - 50
SP - 2432
EP - 2446
JO - Transfusion
JF - Transfusion
SN - 0041-1132
IS - 11
ER -