Factors affecting autologous peripheral blood stem cell collection in patients with relapsed or refractory diffuse large cell lymphoma and Hodgkin lymphoma: A single institution result of 168 patients

Abstract

From 1996 to April 2006, 174 consecutive patients with relapsed or refractory diffuse large cell lymphoma (DLCL) and Hodgkin lymphoma (HL) received ESHAP as salvage and for mobilisation. Males 92, females 76. DLCL 64: HL 104, prior radiation in 35%. First relapse 45%, second relapse 12%, induction failure 43%. Median prior chemotherapy cycles were 6. Median age at apheresis was 26.5 years. Six patients failed mobilisation and 21 patients had CD34+ cells collection < 2 x 10(6)/kg on first apheresis. Median CD34+ cells/kg collection was 5.5 x 10(6)/kg for first apheresis and 6.7 x 10(6)/kg for all apheresis. We evaluated impact of histology, gender, age, stage, marrow involvement, prior radiation and chemotherapy cycles, timing (relapse1: relapse > 1: refractory), platelet count and weight. For first apheresis collection; all patients, younger age (p = 0.004), for DLCL (64), younger age (p = 0.021) and higher platelet count (p = 0.013) and for HL (104), younger age (p = 0.036) and male gender had better CD34+ cells collection. For all apheresis product, for all patients, age (p = 0.001) and no prior radiation therapy (p = 0.051) had better CD34+ cells collection. Higher first harvest CD34+ cells collection also resulted in early neutrophil (p < or = 0.001) and platelet (p = 0.004) engraftment.

Pre-transplant FDG-PET-based survival model in relapsed and refractory Hodgkin’s lymphoma: outcome after high-dose chemotherapy and auto-SCT

“…Salvage chemotherapy, HDC and stem cell mobilization ESHAP (etoposide, solumedrol, cisplatinum and Ara-C) was primarily used as salvage chemotherapy in 133 (94%) patients and also for mobilization regimen for stem cell collection in 108 (77%) as we have reported previously. 23,24 BEAM was used as HDC.…”

Plerixafor with and without chemotherapy in poor mobilizers: results from the German compassionate use program

“…Although poor mobilizers are difficult to identify in advance, the following risk factors for poor mobilization are accepted in general: age 460 years, progressive disease, severe BM involvement, previous chemo-and/or radiotherapy, type of chemotherapy, previously failed mobilization attempts, platelet counts o100 Â 10 9 /L before apheresis and the occurrence of neutropenic fever during mobilization. 3,[9][10][11][12][13] The bicyclam plerixafor (formerly known as AMD3100) was found to interrupt the interaction between the chemokine stroma-derived factor-1 alpha, which is constitutively expressed on BM stromal cells, 14,15 and its cognate receptor CXCR4 on CD34 þ HSC, 16 resulting in a rapid increase of PBSC. 12 Initially designed as a CXCR4 entry-inhibitor for the treatment of HIV-1 infections, 17 the transient leukocytosis monitored in healthy individuals, as well as in HIV positive patients, led to a change in its use.…”

“…3,[9][10][11][12][13] The bicyclam plerixafor (formerly known as AMD3100) was found to interrupt the interaction between the chemokine stroma-derived factor-1 alpha, which is constitutively expressed on BM stromal cells, 14,15 and its cognate receptor CXCR4 on CD34 þ HSC, 16 resulting in a rapid increase of PBSC. 12 Initially designed as a CXCR4 entry-inhibitor for the treatment of HIV-1 infections, 17 the transient leukocytosis monitored in healthy individuals, as well as in HIV positive patients, led to a change in its use. 18,19 In a phase I study a single dose of 240 mg/kg SC plerixafor was as effective as a 5-day mobilization regimen with G-CSF.…”

A plerixafor-based strategy allows adequate hematopoietic stem cell collection in poor mobilizers: results from the Canadian Special Access Program

“…Primary mobilization failure occurs in 5-40% of patients. [5][6][7][8][9] Risk factors for poor mobilization include older age, 10 prior radiation therapy, extensive prior chemotherapy, exposure to lenalidomide or purine analogues and extensive BM involvement by malignancy. [11][12][13] Options for those patients who fail to mobilize are limited.…”