title: Increased efficacy of intermediate-dose cytarabine + G-CSF compared to DHAP + G-CSF for stem cell mobilization in patients with lymphoma: an analysis by the polish lymphoma research group.
abstract: Salvage regimens, like DHAP (dexamethasone, cytarabine, and cisplatin) are frequently used for stem cell mobilization in lymphoma. The aim of this study was to compare the efficacy of DHAP + G-CSF with intermediate-dose cytarabine (ID-AraC) + G-CSF, recently proposed as an alternative schedule. Consecutive patients with Hodgkin's or non-Hodgkin lymphoma who had received at least 2 lines of chemotherapy, mobilized with either DHAP (n = 51) or ID-AraC (n = 50) + G-CSF were included in the analysis. AraC was administered at the dose of 400 mg/m [1] bid intravenously for 2 days followed by filgrastim starting from day 5. In the AraC group, 96 % of patients collected at least 2 × 10 [2] CD34(+) cells/kg compared to 71 % in the DHAP group (p = 0.0006). The CD34(+) cell yield was 9.3 (0-30.3) × 10 [2]/kg vs. 5.6 (0-24.8) × 10 [2]/kg, respectively (p = 0.006). A single apheresis was sufficient to achieve the threshold number of CD34(+) cells in 82 % of the cases after AraC compared to 45 % after DHAP (p = 0.001). We conclude that stem cell mobilization using ID-AraC is associated with a significantly higher efficacy than DHAP, allowing for collection of the transplant material in almost all patients with lymphoma. Our observation suggests that ID-AraC + G-CSF may be a preferable mobilization regimen in this setting.
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland. sgiebel@io.gliwice.pl.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Giebel
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Sadus-Wojciechowska
authors.affiliation: Department of Hematopoietic Cell Transplantation, Institute of Hematology and Blood Transfusion, Str. Indiry Gandhi 14, 02-776, Warsaw, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Halaburda
authors.affiliation: Department of Hematology, Oncology and Internal Diseases, Warsaw Medical University, Str. Banacha 1a, 02-097, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Drozd-Sokolowska
authors.affiliation: Department of Hematology, Lodz Medical University, Str. Pabianicka 62, 93-513, Lodz, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wierzbowska
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Najda
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Wlodzimierz
authors.initials: W
authors.lastname: Mendrek
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Sobczyk-Kruszelnicka
authors.affiliation: Department of Hematology, Lodz Medical University, Str. Pabianicka 62, 93-513, Lodz, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Nowicki
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Holowiecki
authors.affiliation: Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Czerw
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D003907:Dexamethasone; D002945:Cisplatin
keywords: Autologous hematopoietic cell transplantation; Cytarabine; Lymphoma; Stem cell mobilization