Mini-ICE effectively mobilises peripheral blood stem cells after fludarabine-based regimens in acute myeloid leukaemia.
Fludarabine-based cycles severely impair mobilisation and collection of peripheral blood stem cells (PBSC) in acute myeloid leukaemia (AML). In an effort of reversing this side-effect, we studied the action on mobilisation and collection of PBSC of a low-dose regimen: 5-d Mini-ICE (oral idarubicin and etoposide; subcutaneous cytosine arabinoside) administered after fludarabine-based regimens in seven adult AML patients. Leukapheresis were started when the CD34+ cell count was more than 10/microL. The median number of harvested CD34+ cells was 8.1 x 10(6)/kg (range 3.08-15.2). All the patients were successfully submitted to PBSC transplantation. Median times to neutrophil and platelet recovery were rapid with a normal transfusional support. We suggest that the Mini-ICE programme is feasible, well tolerated and effective in terms of PBSC mobilisation and collection in low-yield AML patients previously treated with fludarabine. It is well known that a negative effect on stem cell mobilisation and harvest is observed not only after fludarabine administration in AML or low-grade lymphomas, but also after cycles based on different agents, such as thalidomide in multiple myeloma. This preliminary experience, if confirmed on larger series and/or other haematological malignancies, could open new opportunities to perform autologous PBSC transplantation in heavily pretreated cases, allowing a full source of therapeutic options before the start of the mobilisation process.
Mele
Anna
A
Department of Haematology, Hospital San Salvatore, Pesaro, Italy.
Leopardi
Giuliana
G
Sparaventi
Giovanni
G
Nicolini
Giuseppina
G
D'Adamo
Francesca
F
Guiducci
Barbara
B
Barulli
Sara
S
Malerba
Lara
L
Stramigioli
Stefania
S
Talevi
Nadia
N
Politi
Patrizia
P
Isidori
Alessandro
A
Malagola
Michele
M
Piccaluga
Pierpaolo
P
Visani
Giuseppe
G
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003561:Cytarabine / Q000008:administration & dosage*; D005047:Etoposide / Q000008:administration & dosage*; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage*; D007937:Leukapheresis; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D014182:Transplantation, Autologous; D014740:Vidarabine / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*
D003561:Cytarabine; D005047:Etoposide; D014740:Vidarabine; C024352:fludarabine; D015255:Idarubicin