title: Intermediate-dose Ara-C plus G-CSF for stem cell mobilization in patients with lymphoid malignancies, including predicted poor mobilizers.
abstract: The optimal protocol for mobilization of hematopoietic stem cells in patients with lymphoid malignancies has not been determined so far. We retrospectively analyzed the efficacy and safety of Ara-C at a dose of 1.6 g/m(2) compared with CY at a dose of 4.0 g/m(2), both combined with filgrastim. Seventy and forty-five patients, respectively, were included, among whom 60% were defined as 'predicted poor mobilizers'. The use of Ara-C was associated with significantly higher peak number of circulating CD34(+) cells compared with CY (P<0.0001). In the Ara-C group, 95% of patients with multiple myeloma (MM) collected at least 5 × 10(6) CD34(+) cells/kg required for tandem transplantation, and 97% of lymphoma patients collected at least 2 × 10(6) CD34(+) cells/kg, needed for a single autologous hematopoietic SCT (autoHSCT), which was achieved with a single leukapheresis in 91% of cases. Results for the CY group were significantly inferior (P<0.0001). No patient mobilized with Ara-C experienced febrile neutropenia, whereas 35% required platelet transfusions. Among patients who proceeded to autoHSCT, the time of both neutrophil and platelet recovery was significantly shorter for those mobilized with Ara-C than CY. We conclude that intermediate-dose Ara-C+filgrastim is a very effective and relatively safe mobilization protocol for patients with lymphoid malignancies.
authors.affiliation: Department of Bone Marrow Transplantation, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
authors.forename: S
authors.initials: S
authors.lastname: Giebel
authors.forename: T
authors.initials: T
authors.lastname: Kruzel
authors.forename: T
authors.initials: T
authors.lastname: Czerw
authors.forename: M
authors.initials: M
authors.lastname: Sadus-Wojciechowska
authors.forename: J
authors.initials: J
authors.lastname: Najda
authors.forename: E
authors.initials: E
authors.lastname: Chmielowska
authors.forename: S
authors.initials: S
authors.lastname: Grosicki
authors.forename: A
authors.initials: A
authors.lastname: Jurczyszyn
authors.forename: M
authors.initials: M
authors.lastname: Pasiarski
authors.forename: E
authors.initials: E
authors.lastname: Nowara
authors.forename: M
authors.initials: M
authors.lastname: Glowala-Kosinka
authors.forename: A
authors.initials: A
authors.lastname: Chwieduk
authors.forename: I
authors.initials: I
authors.lastname: Mitrus
authors.forename: A
authors.initials: A
authors.lastname: Smagur
authors.forename: J
authors.initials: J
authors.lastname: Holowiecki
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D064592:Autografts; D003561:Cytarabine / Q000008:administration & dosage*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D009503:Neutropenia / Q000209:etiology / Q000628:therapy; D017713:Platelet Transfusion; D013997:Time Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor