Keywords
hematopoietic stem cell mobilization
cytarabine
cyclophosphamide
plerixafor
G-CSF
poor HSC mobilization
How to Cite
Keywords
Abstract
AIM. To compare the efficacy and toxicity of various regimens of autologous hematopoietic stem cell (HSC) mobilization (cytarabine + G-CSF, cyclophosphamide + G-CSF, and plerixafor + G-CSF) in hematologic malignancy patients with predicted poor HSC collection.
MATERIALS & METHODS. This retrospective study compared the results of autologous HSC mobilization in peripheral blood of 87 hematologic malignancy patients with predicted poor collection. Out of them, 36 patients received cytarabine 400 mg/m2/12 h IV on Day 1 and Day 2 combined with G-CSF 10 µg/kg SC from Day 5 to the last apheresis. In 18 patients, to mobilize autologous HSCs, cyclophosphamide 2–4 g/m2 IV on Day 1 + G-CSF 10 µg/kg SC also from Day 5 were used. The third regimen of autologous HSC mobilization (n = 33) started with G-CSF 10 µg/kg/day SC on Days 1, 2, 3, 4, and 5, and plerixafor 0.24 µg/kg/day SC was administered on Day 5. The analysis focused on the data from 27 classical Hodgkin lymphoma (cHL), 44 non-Hodgkin lymphoma (NHL), and 16 multiple myeloma patients. The median age was 48, 33, and 55 years, respectively.
RESULTS. The median CD34+ cell collection was 8.1 × 106/kg body mass in cytarabine + G-CSF recipients vs. 6.5 × 106/kg in cyclophosphamide + G-CSF and 2.8 × 106/kg in plerixafor + G-CSF recipients (p < 0.0001). Most common complications were thrombocytopenia grade 4 (in 44 % of cytarabine + G-CSF and 6 % of cyclophosphamide + G-CSF recipients; p = 0.004) and neutropenia grade 4 (in 42 % of cytarabine + G-CSF and 22 % of cyclophosphamide + G-CSF recipients; p = 0.23).
CONCLUSION. Cytarabine + G-CSF mobilization of autologous HSCs can well be considered to be an effective and safe regimen for cHL and NHL predicted poor mobilizers. This conclusion, however, does not apply, for a number of reasons, to plasma cell tumor patients. For this category, the determination of an optimal autologous HSC mobilization regimen still remains a highly relevant issue.
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