title: DHAP regimen plus G-CSF as salvage therapy and priming for blood progenitor cell collection in patients with poor prognosis lymphoma.
abstract: We studied 14 patients affected by lymphoma to assess the toxicity, efficacy and mobilization capability of salvage DHAP regimen followed by G-CSF 5 micrograms/kg/day. Ten patients were affected by intermediate-grade NHL and 4 by HD; all of them were in relapse or in PR. We administered a total of 34 courses of DHAP plus G-CSF (median 2 per patient; range 1-5) and did not observe either life-threatening extrahematologic toxicity or severe infections during the short neutropenic period. A significant tumor burden reduction was observed in 86% of patients (50% CR, 36% PR). A total of 35 aphereses were performed (median 3 per patient; range 1-5). The hemopoietic progenitors showed a very rapid increase from day +11 with a synchronous and impressive peak on day +13. We collected a median of 2.6 x 10(6)/kg CD34+ cells, 10 x 10(4)/kg CFU-GM, 5 x 10(4)/kg BFU-E and 0.5 x 10(4)/kg CFU-GEMM per apheresis. All patients transplanted with PBPC had a rapid and sustained hematological recovery. The DHAP regimen followed by G-CSF proved to be a very effective and well-tolerated schedule for debulking disease before transplantation and for enhancing progenitor cell mobilization.
authors.affiliation: Department of Hematology, University of Ancona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Olivieri
authors.forename: M
authors.initials: M
authors.lastname: Offidani
authors.forename: L
authors.initials: L
authors.lastname: Ciniero
authors.forename: I
authors.initials: I
authors.lastname: Cantori
authors.forename: L
authors.initials: L
authors.lastname: Ombrosi
authors.forename: S
authors.initials: S
authors.lastname: Mancini
authors.forename: M C
authors.initials: MC
authors.lastname: Masia
authors.forename: P
authors.initials: P
authors.lastname: Scalari
authors.forename: P
authors.initials: P
authors.lastname: Leoni
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002452:Cell Count; D002469:Cell Separation; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000009:adverse effects / Q000627:therapeutic use; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000473:pathology*; D006801:Humans; D007937:Leukapheresis; D008223:Lymphoma / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016879:Salvage Therapy
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D003907:Dexamethasone; D002945:Cisplatin