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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
Author(s) -
Zhang Cheng,
Chen XingHua,
Gao Li,
Liu Yao,
Gao Lei,
Kong PeiYan,
Zeng DongFeng,
Peng XianGui,
Sun AiHua,
Zhang Xi
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12516
Subject(s) - hodgkin lymphoma , methotrexate , medicine , lymphoma , single center , haematopoiesis , oncology , center (category theory) , mobilization , hematopoietic stem cell transplantation , stem cell , biology , transplantation , chemistry , political science , genetics , law , crystallography
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 .