title: Mini-ICE effectively mobilises peripheral blood stem cells after fludarabine-based regimens in acute myeloid leukaemia.
abstract: 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.
authors.affiliation: Department of Haematology, Hospital San Salvatore, Pesaro, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Mele
authors.forename: Giuliana
authors.initials: G
authors.lastname: Leopardi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sparaventi
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Nicolini
authors.forename: Francesca
authors.initials: F
authors.lastname: D'Adamo
authors.forename: Barbara
authors.initials: B
authors.lastname: Guiducci
authors.forename: Sara
authors.initials: S
authors.lastname: Barulli
authors.forename: Lara
authors.initials: L
authors.lastname: Malerba
authors.forename: Stefania
authors.initials: S
authors.lastname: Stramigioli
authors.forename: Nadia
authors.initials: N
authors.lastname: Talevi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Politi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Isidori
authors.forename: Michele
authors.initials: M
authors.lastname: Malagola
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Piccaluga
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Visani
mesh_terms: 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*
chemical_list: D003561:Cytarabine; D005047:Etoposide; D014740:Vidarabine; C024352:fludarabine; D015255:Idarubicin