title: Factors associated with successful mobilization of peripheral blood progenitor cells in 200 patients with lymphoid malignancies.
abstract: Peripheral blood progenitor cells (PBPC) were mobilized and harvested in 200 patients treated for non-Hodgkin's lymphoma (n = 148), Hodgkin's disease (n = 22) and multiple myeloma (n = 30). The variables predicting the collection of a minimal (>2.5 x 10(6)/kg) or a high (>10 x 10(6)/kg) CD34+ cell count were analysed. Patients were mobilized with haemopoietic growth factors following either standard chemotherapy (n = 49) or high-dose cyclophosphamide, given alone (n = 55) or combined with high-dose VP16 (n = 86). 10 patients received haemopoietic growth factors only. The first mobilization resulted in a PBPC harvest with enough CD34+ cells in 179/200 patients (90%). High-dose cyclophosphamide, with or without VP16, did not mobilize a higher progenitor cell yield than standard chemotherapy. When performing multiple regression analysis in the 190 patients who received chemotherapy-containing mobilization, only the number of previous chemotherapy regimens and the exposure to fludarabine predicted for a failure to collect a minimal PBPC count (P=0.06 and 0.0008 respectively). The target to collect a high CD34+ cell count was negatively associated with the number of previous chemotherapy regimens (P=0.002). When only non-Hodgkin's lymphoma patients were considered for multivariate analysis, low-grade histology with fludarabine appeared to be associated with poor PBPC cell yield (P=0.08 and 0.005 respectively). This data confirms that PBPC harvest should be planned early in the disease course in transplant candidates, and can be obtained after a standard course of chemotherapy.
authors.affiliation: Service d'Hématologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon and UPRES-JE 1879 Hémopathies Lymphoïdes Malignes, Université Claude Bernard, Pierre-Bénite, France.
authors.forename: N
authors.initials: N
authors.lastname: Ketterer
authors.forename: G
authors.initials: G
authors.lastname: Salles
authors.forename: I
authors.initials: I
authors.lastname: Moullet
authors.forename: C
authors.initials: C
authors.lastname: Dumontet
authors.forename: A
authors.initials: A
authors.lastname: ElJaafari-Corbin
authors.forename: P
authors.initials: P
authors.lastname: Tremisi
authors.forename: C
authors.initials: C
authors.lastname: Thieblemont
authors.forename: B
authors.initials: B
authors.lastname: Durand
authors.forename: E M
authors.initials: EM
authors.lastname: Neidhardt-Berard
authors.forename: H
authors.initials: H
authors.lastname: Samaha
authors.forename: D
authors.initials: D
authors.lastname: Rigal
authors.forename: B
authors.initials: B
authors.lastname: Coiffier
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016207:Cytokines / Q000627:therapeutic use*; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000378:metabolism; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D007937:Leukapheresis; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D016207:Cytokines