title: Poor mobilization is an independent prognostic factor in patients with malignant lymphomas treated by peripheral blood stem cell transplantation.
abstract: Haemopoietic stem cell therapy is an increasingly adopted procedure in the treatment of patients with malignant lymphoma. In this retrospective analysis, we evaluated 262 patients, 57 (22%) with Hodgkin's and 205 (78%) with non-Hodgkin's lymphomas (NHL), and 665 harvesting procedures in order to assess the impact of poor mobilization on survival and to determine the factors that may be predictive of CD34(+) poor mobilization. The mobilization chemotherapy regimens consisted of high-dose cyclophosphamide in 92 patients (35.1%) and a high-dose cytarabine-containing regimen (DHAP in 87 patients -(33.2%), MAD in 83 (31.7%)). The incidence of poor mobilizers (<2 x 10(6) CD34(+) cells/kg) was 17.9% overall, with a 10% of very poor mobilizers (< or = 1 x 10(6)/kg). Refractory disease status and chemotherapeutic load (>3 regimens) before mobilization played a negative role and were associated with poor mobilization. Survival analysis of all harvested patients showed an overall survival at 3 years of 71% in good mobilizers vs 33% in poor mobilizers (P=0.002). The event-free survival at 3 years was 23% in poor mobilizers and 58% in good mobilizers (P=0.04). We conclude that in NHL patients, poor mobilization status is predictive of survival.
authors.affiliation: Hematology Department, University of Bari, Bari, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Pavone
authors.forename: F
authors.initials: F
authors.lastname: Gaudio
authors.forename: G
authors.initials: G
authors.lastname: Console
authors.forename: U
authors.initials: U
authors.lastname: Vitolo
authors.forename: P
authors.initials: P
authors.lastname: Iacopino
authors.forename: A
authors.initials: A
authors.lastname: Guarini
authors.forename: V
authors.initials: V
authors.lastname: Liso
authors.forename: T
authors.initials: T
authors.lastname: Perrone
authors.forename: A
authors.initials: A
authors.lastname: Liso
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000096:biosynthesis; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008223:Lymphoma / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013234:Stem Cells / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D000970:Antineoplastic Agents