Prospective noninterventional study on peripheral blood stem cell mobilization in patients with relapsed lymphomas.
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) to rescue hematopoiesis is considered standard care for patients with a relapsed chemosensitive lymphoma, but diagnosis of lymphoma has been a risk factor for poor mobilization in several studies. The aim of this prospective noninterventional clinical audit was to review the mobilization strategies used by EBMT centers in relapsed lymphoma and to evaluate their efficacy. Between 2010 and 2014, 275 patients with relapsed lymphoma from 30 EBMT centers were prospectively registered. Almost all patients were mobilized with chemotherapy plus G-CSF (96%), but there was a large variation in chemotherapy schedules. Thirty (11%) of them were poor mobilizers (<2 × 106CD 34+ cells/kg body weight) at the first mobilization. Poor mobilization was not associated with gender, age, bone marrow involvement at diagnosis, primary diagnosis, number of previous chemotherapy lines, previous radiotherapy or mobilization with G-CSF alone. The use of high dose cyclophosphamide alone was associated with mobilization failure (P = 0.0006), whereas the use of a platinum-containing regimen was associated with a good mobilization outcome (P = 0.013). Because failure rate is low, we can conclude from this study that PBSC mobilization failure in relapsed lymphomas is not an important problem in the EBMT centers.
Department of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands.
Gwendolyn
G
van Gorkom
EBMT Lymphoma Working Party, Paris, France.
Herve
H
Finel
Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
Sebastian
S
Giebel
Department of Medicine, Charles University Hospital, Prague, Czech Republic.
David
D
Pohlreich
Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Avichai
A
Shimoni
Department of Medicine III, Klinikum Karlsruhe, Karlsruhe, Germany.
Mark
M
Ringhoffer
Department of Hematology, Gazi University, Ankara, Turkey.
Gülsan
G
Sucak
Department of Hematology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Nicolaas
N
Schaap
EBMT Lymphoma Working Party, Paris, France.|Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
Peter
P
Dreger
Hematology Department, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain.
Anna
A
Sureda
Department of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands.
Harry C
HC
Schouten
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D054869:Clinical Audit; D003131:Combined Modality Therapy; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D008223:Lymphoma / Q000097:blood* / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D000072916:Peripheral Blood Stem Cells / Q000473:pathology*; D011446:Prospective Studies; D012008:Recurrence; D014182:Transplantation, Autologous; D017211:Treatment Failure; D055815:Young Adult
relapsed lymphomas; stem cell mobilization