Prediction of mobilisation failure in patients with non-Hodgkin's lymphoma.
Factors affecting progenitor cell mobilisation in patients with non-Hodgkin's lymphoma (NHL) are incompletely understood. We have analysed factors predicting mobilisation failure in 97 consecutive patients with NHL (59 males, 38 females; median age 49 years) who received mobilisation with intermediate-dose CY (4 g/m(2)) followed by G-CSF. The histology included large cell B (N=50), mantle cell (N=16), follicular (N=16) and other NHL (N=15). The disease status was 1CR/PR/primary refractory in 66 patients and >1 CR/PR in 31 patients. The minimum criterion for successful mobilisation was the collection of >or=1.5 x 10(6)/kg CD34(+) cells. In all, 18 patients (19%) failed to reach this threshold. In univariate analysis, premobilisation factors associated with mobilisation failure included BM involvement at the time of diagnosis (P=0.001) or prior to mobilisation (P=0.001) and low platelet count just prior to mobilisation (P=0.001). In multivariate analysis, only BM involvement at diagnosis (P=0.004) and platelet count just prior to mobilisation (P=0.01) were associated with mobilisation failure. A mathematical model based on these two factors and presented in the form of a receiver operating characteristics curve showed a sensitivity of 0.71 and a specificity of 0.77 in the prediction of mobilisation failure. Patients at a high risk of mobilisation failure may benefit from novel approaches.
Kuittinen
T
T
Department of Medicine, Kuopio University Hospital, Kuopio, Finland. taru.kuittinen@kuh.fi
Nousiainen
T
T
Halonen
P
P
Mahlamäki
E
E
Jantunen
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000737:chemistry; D001853:Bone Marrow / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015999:Multivariate Analysis; D012372:ROC Curve; D012306:Risk; D012680:Sensitivity and Specificity; D013234:Stem Cells / Q000378:metabolism; D016896:Treatment Outcome
D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor