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MedLine Citation:
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PMID: 11342334 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M W Sugrue; K Williams; B H Pollock; S Khan; S Peracha; J R Wingard; J S Moreb |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: Leukemia & lymphoma Volume: 39 ISSN: 1042-8194 ISO Abbreviation: Leuk. Lymphoma Publication Date: 2000 Nov |
Date Detail:
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Created Date: 2001-05-08 Completed Date: 2001-10-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9007422 Medline TA: Leuk Lymphoma Country: Switzerland |
Other Details:
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Languages: eng Pagination: 509-19 Citation Subset: IM |
Affiliation:
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University of Florida, Gainesville, FL 32610-0277, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Actuarial Analysis Adolescent Adult Aged Antigens, CD34 / analysis Cohort Studies Female Graft Survival Hematopoietic Stem Cell Mobilization / standards* Hematopoietic Stem Cell Transplantation* / standards Hodgkin Disease / therapy Humans Kinetics Lymphoma / therapy* Lymphoma, Non-Hodgkin / therapy Male Middle Aged Risk Factors Stem Cells / immunology Survival Rate Transplantation, Autologous / standards* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antigens, CD34 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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