Very high efficacy of intermediate-dose cytarabine in combination with G-CSF as a second-line mobilization of hematopoietic stem cells

Intermediate-dose Ara-C plus G-CSF for stem cell mobilization in patients with lymphoid malignancies, including predicted poor mobilizers

“…Leukaphereses were started significantly later in patients receiving Ara-C þ G-CSF than CY þ G-CSF (day 14 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) versus day 12 (11)(12)(13)(14)(15)(16)(17)(18)(19), Po0.0001). In the Ara-C group, 57 patients (84%) were started stem cell harvest between day 13 and 15, most frequently on day 14 (28 patients, 41%).…”

“…Both doses appeared highly effective allowing adequate CD34 þ cell harvest in 14 consecutive cases. 26 As a consequence, we decided to change our standard operating procedures and introduce intermediate-dose Ara-C þ G-CSF as the first-line mobilization for patients with lymphoid malignancies. In this study, we retrospectively analyzed the efficacy and toxicity of Ara-C þ G-CSF in comparison with CY þ G-CSF.…”

Intermediate doses of cytarabine plus granulocyte–colony‐stimulating factor as an effective and safe regimen for hematopoietic stem cell collection in lymphoma patients with prior mobilization failure

“…In contrast to our series of patients, regimens were administered during the hospital stay whereas the procedure detailed in this article was a totally outpatient schema. Moreover, they also included patients who were not poor mobilizers . Additionally, Park and coworkers published a total of eight patients with prior mobilization failure (two multiple myeloma and six NHL) that received, on an inpatient regimen, methotrexate, cytarabine (3 g/m 2 ), and G‐CSF, describing a success rate of 75% with a total of three to five apheresis procedures.…”

“…Approaches to rescue patients with a prior failed mobilization greatly vary among centers and include increased doses of granulocyte–colony‐stimulating factor (G‐CSF) with or without chemotherapy. Among these, regimens based on the use of G‐CSF plus etoposide, cyclophosphamide, or intermediate‐ or high‐dose cytarabine have been reported, but scarce and heterogeneous experience has been reported among patients with a previous mobilization failure, with a success rate lower than 50% …”

“…Among these, regimens based on the use of G-CSF plus etoposide, cyclophosphamide, or intermediate-or high-dose cytarabine have been reported, but scarce and heterogeneous experience has been reported among patients with a previous mobilization failure, with a success rate lower than 50%. [10][11][12][13][14][15][16][17][18][19] The recent introduction of new drugs such as plerixafor, with or without chemotherapy, is probably one of the most promising approaches and allows to obtain the CD34+ cell target dose in more than 70% of these patients. [20][21][22][23][24] Nevertheless, it is noteworthy that plerixaforcontaining regimens still have a 30% failure rate among prior failed mobilizers.…”