Document Detail

MedLine Citation:
PMID:  11342334     Owner:  NLM     Status:  MEDLINE    
A "hard to mobilize" patient was defined as one in whom >or= 1x10(6) CD 34+ cells/kg cannot be obtained after two consecutive large volume aphereses. Forty-four consecutive Hodgkin's and non-Hodgkin's lymphoma patients who underwent autologous peripheral blood stem cell (PBSC) transplant treatment between June 1996 and June 1998 were included in this study. Twenty-one patients (48%) met the definition of "hard to mobilize" (Group I). All the rest of the patients (n=23) were the good mobilizers (Group II). The initial mobilization protocol for most patients was 10 microg/kg of G-CSF alone for both groups. For Group I, 7/21 (33%) patients were unable to achieve a minimal dose of >or= 1x10(6) CD34+ cells/kg even after a second mobilization attempt and/or bone marrow (BM) harvest (n=5). Overall, 11/21 (52%) required an additional mobilization and/or BM harvest. Only 3/21 (14%) patients were able to meet the target cell dose of >or= 2.5x10(6) CD34+ cells/kg (median of 4 apheresis). In contrast, 87% of Group II achieved the target dose with a median of 2 aphereses. Predictors of poor mobilization were greater than two prior treatment regimens (p=0.038) and the WBC count (<25,000/microL) on the first day of apheresis (p=0.053). Nineteen patients in Group I and all Group II completed treatment with a median time to engraftment of ANC>500/microl of 12 and 11 days, and platelet >20x10(3)/microl of 31 and 13 days, respectively. Outcome analysis revealed that 6/19 patients in Group I died of relapse within one year from transplant compared with only 2/23 of Group II who died of relapse (p=0.005, log rank test). There were no treatment related deaths in either group. Independent predictive features for "hard to mobilize" patients are a lack of significant increase in WBC count on the first day of apheresis and the number of prior treatment regimens. Poor mobilization appears to predict a worse outcome after autografting for lymphoma patients.
M W Sugrue; K Williams; B H Pollock; S Khan; S Peracha; J R Wingard; J S Moreb
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Leukemia & lymphoma     Volume:  39     ISSN:  1042-8194     ISO Abbreviation:  Leuk. Lymphoma     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-05-08     Completed Date:  2001-10-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9007422     Medline TA:  Leuk Lymphoma     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  509-19     Citation Subset:  IM    
University of Florida, Gainesville, FL 32610-0277, USA.
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MeSH Terms
Actuarial Analysis
Antigens, CD34 / analysis
Cohort Studies
Graft Survival
Hematopoietic Stem Cell Mobilization / standards*
Hematopoietic Stem Cell Transplantation* / standards
Hodgkin Disease / therapy
Lymphoma / therapy*
Lymphoma, Non-Hodgkin / therapy
Middle Aged
Risk Factors
Stem Cells / immunology
Survival Rate
Transplantation, Autologous / standards*
Treatment Outcome
Reg. No./Substance:
0/Antigens, CD34

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