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The Hyper‐CVAD chemotherapy regimen has an adverse long‐term impact on the ability to mobilize peripheral blood stem cells, which can be readily circumvented by using the early cycles for mobilization
Author(s) -
Keane Colm,
Gibbs Simon,
Seymour John F,
Mills Anthony K,
Grimmett Karen,
Kuilenberg Rosita Van,
Saal Russell,
Gill Devinder,
Prince H Miles,
Marlton Paula,
Mollee Peter
Publication year - 2006
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.784
Subject(s) - medicine , regimen , chemotherapy , apheresis , adverse effect , mobilization , stem cell , cd34 , surgery , platelet , biology , genetics , archaeology , history
The Hyper‐CVAD chemotherapy regimen is being increasingly applied to a number of haematological malignancies. We assessed the impact of Hyper‐CVAD on peripheral blood stem cell (PBSC) yields and examined the optimal timing of PBSC collection when using this regimen. Seventy‐four consecutive patients were identified in whom an attempt was made to collect PBSC, usually on recovery from cycle A or B. Where PBSC collection was attempted after cycle 3B, only 18% (3/17) of patients successfully mobilized. Fifty‐seven patients were mobilized on recovery from cycle 1B ( n = 13), 2A ( n = 22), 2B ( n = 14) or 3A ( n = 8). Compared with cycle 2A, 1B was not superior in achieving the minimum of ≥2 × 10 6 /kg CD34+ cells (100% vs. 77%, p = 0.13), but was superior in terms of total CD34+ yield (21.4 vs. 3.2 × 10 6 /kg, p < 0.001), achieving the target CD34+ cell count of ≥5 × 10 6 /kg (92% vs 36%, p = 0.002), and obtaining both a minimum (92% vs. 18%, p < 0.001) and target (77% vs. 0%, p < 0.001) graft with a single apheresis. There were no significant differences in PBSC yields following cycles 2A, 2B and 3A. Hyper‐CVAD has substantial stem cell toxicity which can be readily circumvented by using the early chemotherapy cycles for mobilization. Copyright © 2006 John Wiley & Sons, Ltd.