Successful CD34+ cell mobilization by intermediate-dose Ara-C in chronic lymphocytic leukemia patients treated with sequential fludarabine and Campath-1H

Montillo, Marco; Tedeschi, Alessandra; Rossi, Valentina; Cairoli, Roberto; Pungolino, Ester; Intropido, Liliana; Cafro, Anna Maria; D’Avanzo, Giovanna; Farioli, Renata; Brando, Bruno; Scarpati, Barbara; Veronese, Silvio; Morra, Enrica

doi:10.1038/sj.leu.2403190

Cited by 44 publications

(27 citation statements)

References 29 publications

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“…On the other hand, only one out of five patients mobilized with G-CSF alone reached the collection target in this series. Interestingly, cytarabine appeared to be efficient in re-mobilization in this series (success in 5/5 patients) as well in a previous series by Montillo et al 15 (success in 13/14). Further, a recent French trial suggested a higher success rate after DHAP (dexamethasone-cytarabine-cisplatinum) when compared to mobilization with G-CSF alone in fludarabine-treated CLL patients.…”

Section: Discussionsupporting

confidence: 66%

Blood stem cell mobilization and collection in patients with chronic lymphocytic leukaemia: a nationwide analysis

Jantunen

Itälä

Siitonen

et al. 2007

Bone Marrow Transplant

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Section: Discussionsupporting

confidence: 66%

Blood stem cell mobilization and collection in patients with chronic lymphocytic leukaemia: a nationwide analysis

Jantunen

Itälä

Siitonen

et al. 2007

Bone Marrow Transplant

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“…Tournilhac et al 6 reported a series of 38 CLL patients treated similarly, who were mobilized with filgrastim 10 mg/kg/day, and only 16% achieved the target of 2 Â 10 6 CD34 þ cells/kg bw and repeated mobilizations using the same procedure were likewise effective. A similar inefficiency of G-CSF alone in standard doses (5 mg/kg) was observed by Montillo et al, 10 eight out of 10 CLL patients treated upfront with FLU and Campath-1H failed to mobilize. Furthermore, increasing the dose of G-CSF to 10 mg proved to be an unsuccessful measure.…”

Section: -Test)mentioning

confidence: 69%

“…[4][5][6] The high rate of primary mobilization failures in the whole study group supports this presumption. The rationale for our remobilization strategy was the reported dose-dependent G-CSF efficacy in PBSC mobilization [8][9][10] and avoidance of toxicity of mobilizing chemotherapy. Kobbe et al 8 noted that the higher G-CSF dose was associated with higher levels of CD34 þ cells and a higher percentage of successful collections.…”

Section: -Test)mentioning

confidence: 99%

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Inefficiency of high-dose G-CSF alone as second mobilization regimen in fludarabin-cyclophosphamide-treated CLL patients who failed to mobilize after chemotherapy and G-CSF

Jindra¹,

Koza²,

Lysák³

et al. 2005

Bone Marrow Transplant

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“…Concern has been raised regarding the ability to mobilize sufficient PBPCs for autografting after purine analogues in AML 32 as well as in lymphoproliferative disorders. 33 However, after conventional FLAG therapy, we previously reported a mobilization rate comparable to that observed in this series in AML with trilinear dysplastic abnormalities; 18 in addition, we cannot exclude the possibility that fludarabine given as CI can result in less impairment of stem cell mobilization capacity.…”

Section: Discussionmentioning

confidence: 87%

Continuous infusion idarubicin and oral busulfan as conditioning for patients with acute myeloid leukemia aged over 60 years undergoing autologous stem cell transplantation

Ferrara¹,

Palmieri²,

Annunziata³

et al. 2004

Bone Marrow Transplant

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Summary:There is growing interest in autologous stem cell transplantation (ASCT) for elderly patients with acute myeloid leukemia (AML). While mortality and toxicity from ASCT have been reduced, relapse rate is still high. In a prospective study, we investigated the feasibility of a new conditioning regimen consisting of high-dose idarubicin plus busulfan in AML patients aged over 60 years undergoing ASCT. A total of 14 patients (median age: 64 years) received 2 days continuous infusion of idarubicin at 20 mg/m 2 /day, followed by 3 days of oral busulfan (4 mg/kg/day) as conditioning. No case of transplantrelated mortality occurred. The median number of days to neutrophil (40.5 Â 10 9 /l) and platelet (420 Â 10 9 /l) recovery was 11 and 12, respectively. Cardiac toxicity was absent, while 12 patients (86%) had grade 3-4 mucositis. After a median follow-up of 9 months from ASCT, nine of 14 patients are alive in continuous complete remission (CR), four have relapsed at 3, 6, 8 and 9 months, and one died in CR1 from gastric cancer. Our data demonstrate the feasibility of a conditioning regimen based on high-dose idarubicin plus busulfan in elderly AML patients. Results concerning reduction of relapse rate need confirmation in a larger series with longer follow-up. The prognosis of acute myeloid leukemia (AML) in older individuals is still poor, due to either lower complete remission (CR) rate or higher incidence of relapse as compared to young/adult patients. [1][2][3][4][5] In an attempt to reduce the relapse rate, there is a growing interest in autologous stem cell transplantation (ASCT) for elderly patients with AML. 6,7 Nevertheless, despite a progressive reduction in transplant-related mortality (TRM) and toxicity, the overall relapse incidence after ASCT remains high. The combination of busulfan and cyclophosphamide, originally designed for allogeneic SCT by the Baltimore team (BuCy) 8 and then its modification by the Columbus team (BuCy2), 9 remains the most frequently used conditioning regimen for ASCT in AML. In the autologous setting, alternative chemotherapy combinations have been proposed to induce superior antileukemic activity and/or reduce toxicity. [10][11][12] In particular, a recent survey from the European Cooperative Group for Blood and Marrow Transplantation (EBMT) reported that the BAVC regimen (BCNU 800 mg/ m 2 , amsacrine 150 mg/m 2 /day for 3 days, VP-16 150 mg/m 2 / day for 3 days and ara-C 300 mg/m 2 /day for 3 days) demonstrated comparable survival with lower TRM. 13 In young/adult AML patients, we previously demonstrated the feasibility and efficacy of an original conditioning regimen, called IBu, consisting of high-dose idarubicin (IDA) administered at 20 mg/m 2 /day as continuous infusion (CI) for 3 days (day -13 to day -11) followed by oral busulfan (Bu) given at 4 mg/kg/day from day -5 to day -2. 12 This regimen relies on the adoption of high-dose CI idarubicin as well as on the removal of cyclophosphamide to increase antileukemic activity.Here, we report results of a prospective st...

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Successful CD34+ cell mobilization by intermediate-dose Ara-C in chronic lymphocytic leukemia patients treated with sequential fludarabine and Campath-1H

Cited by 44 publications

References 29 publications

Blood stem cell mobilization and collection in patients with chronic lymphocytic leukaemia: a nationwide analysis

Blood stem cell mobilization and collection in patients with chronic lymphocytic leukaemia: a nationwide analysis

Inefficiency of high-dose G-CSF alone as second mobilization regimen in fludarabin-cyclophosphamide-treated CLL patients who failed to mobilize after chemotherapy and G-CSF

Continuous infusion idarubicin and oral busulfan as conditioning for patients with acute myeloid leukemia aged over 60 years undergoing autologous stem cell transplantation

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