Akademik Veri Yönetim Sistemi
EUROPEAN JOURNAL OF HAEMATOLOGY, cilt.92, sa.5, ss.390-397, 2014 (SCI-Expanded)
The optimal mobilization strategy prior to autologous stem cell transplantation (auto-SCT) for patients with lymphoma is yet to be determined. We reviewed our institutional experience using chemomobilization with high-dose (HD) etoposide (1.6g/m(2)) and G-CSF (300 mu g/day) in 79 patients with lymphoma. The majority (76%) had received at least two prior regimens of chemotherapy, and 12 (15.2%) patients had previously failed to mobilize following HD cyclophosphamide or DHAP or ICE with G-CSF. HD etoposide and G-CSF chemomobilization resulted in successful collection (>2x10(6) CD34+ cells/kg) in 82.3% of patients within a median 2 (1-6) apheresis days. Patients had stem cells collected between days +8 and +15, with a median +12day. Median total CD34+ cells/kg collected was 5.95x10(6) (0.1-36.8). Seventy-one percent of patients yielded >2x10(6) CD34+ cells/kg in <= 2d of apheresis and were defined as good mobilizers. While median CD34+ cells/kg collected for good mobilizers was 7.6x10(6), it was 2.6x10(6) for poor mobilizers (P<0.001). This regimen was safe with a low rate of febrile neutropenia (7.6%) and acceptable rates of RBC (40.5%) and platelet transfusions (22.8%). Hematopoietic recovery after auto-SCT was achieved on expected time. Therapy-related myelodysplastic syndrome/acute myeloid leukemia occurred in only one patient (1.3%) with in a median follow-up of 16months after chemomobilization. We conclude that HD etoposide and G-CSF chemomobilization appear to result in effective, tolerable, and safe stem cell collection in the majority of heavily pretreated lymphoma patients.