Predictors for successful mobilization of peripheral blood progenitor cells with ESHAP + G-CSF in patients with pretreated non-Hodgkin's lymphoma.
BACKGROUND
ESHAP (etoposide/methylprednisolone/cytarabine/cisplatin) plus granulocyte-colony stimulating factor (G-CSF) is an effective regimen of therapy for advanced non-Hodgkin's lymphoma (NHL) and peripheral blood progenitor cell (PBPC) mobilization. However, the timing of PBPC harvest following immobilization and factors to predict optimal PBPC yield remain to be explored. We herein analyzed the factors potentially correlated to optimal PBPC mobilization.


METHODS
Twenty patients with pretreated advanced NHL were recruited and mobilized with ESHAP + G-CSF followed by 2 leukaphereses, which were initiated once the white blood cell count (WBC) in peripheral blood exceeded 10 x 10(9)/L.


RESULTS
Total CD34+ cells collected by 2 leukaphereses were > 2 x 10(6)/kg body weight in 16 patients; between 1.0 and 2.0 x 10(6)/kg in another 3, and < 1 x 10(6)/kg in the remaining 1 patient. The pre-leukapheresis peripheral blood CD34+ cell counts, available for 28 leukaphereses, correlated linearly with the CD34+ cell yields (r2 = 0.870, p < 0.001). The CD34+ cell yield with pre-leukapheresis peripheral blood CD34+ cell count > or = 50 x 10(6)/L was higher than that with < 50 x 10(6)/L (5.60 +/- 4.32 vs. 0.96 +/- 0.56 x 10(6)/kg/leukapheresis; p = 0.004). Other factors predictive of favorable PBPC yield included preceding chemotherapy cycles < 6 and peripheral blood WBC > 3,500/microL on the day of mobilization chemotherapy (p = 0.032 and 0.013, respectively).


CONCLUSIONS
The pre-leukapheresis peripheral blood CD34+ cell count correlates well with PBPC yields. Less than 6 chemotherapy cycles before mobilization and adequate peripheral blood WBC before mobilization chemotherapy also predict a favorable PBPC yield.
Division of Hematology/Oncology, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. jhwang.liu@msa.hinet.net
Jin-Hwang
JH
Liu
Chih-Cheng
CC
Chen
Li-Yen
LY
Bai
Shu-Chauo
SC
Chao
Mu-Shin
MS
Chang
Jeong-Shi
JS
Lin
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001772:Blood Cell Count; D002945:Cisplatin / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007937:Leukapheresis; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation
D018952:Antigens, CD34; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D002945:Cisplatin; D008775:Methylprednisolone