High‐dose methotrexate in the mobilization of hematopoietic stem cells for patients with non‐ H odgkin's lymphoma: a twelve‐year study in a single center

Background High‐dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto‐ HSCT ) is a promising approach for non‐ H odgkin's lymphoma ( NHL ). Higher cell doses have been associated with a faster blood count recovery and a reduction in transfusion requirements, infection rates, and hospitalization times. Mobilization failure constitutes one of the main reasons for avoiding auto‐ HSCT . The role of high‐dose methotrexate ( MTX ) as mobilization regimen is still unclear. Study Design and Methods The effect of high‐dose MTX as a mobilization regimen for 67 adult patients with NHL who received auto‐ HSCT was studied between J anuary 2001 and O ctober 2012. The stem cells were mobilized using combination chemotherapy including MTX plus granulocyte–colony‐stimulating factor ( G ‐ CSF ) in 33 patients ( G roup A ), and the stem cells of the other 34 patients were mobilized using the same combination chemotherapy plus G ‐ CSF without MTX ( G roup B ). Results All of the patients were successfully mobilized in G roup A ; however, two patients failed in G roup B . The median numbers of CD 34+ cells collected were 14.36 × 10 6 and 5.3 × 10 6 cells/kg for G roups A and B , respectively (p < 0.05). All of the patients experienced a stable neutrophil and platelet (PLT) engraftment. The times to white blood cell engraftment were 8.0 days in G roup A and 11.0 days in G roup B , and the times to PLT engraftment were 12.0 days in G roup A and 13.0 days in G roup B (p < 0.05 for both variables). Conclusion High‐dose MTX is a powerful regimen component for stem cell mobilization in adult patients with NHL .