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Intermediate doses of cytarabine plus granulocyte–colony‐stimulating factor as an effective and safe regimen for hematopoietic stem cell collection in lymphoma patients with prior mobilization failure
Author(s) -
CalderónCabrera Cristina,
Carmona González Magdalena,
Martín Jesús,
Ríos Herranz Eduardo,
Noguerol Pilar,
De la Cruz Fátima,
Carrillo Estrella,
Falantes Jose F.,
Parody Rocío,
Espigado Ildefonso,
PérezSimón Jose A.
Publication year - 2015
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.12906
Subject(s) - medicine , cytarabine , regimen , granulocyte colony stimulating factor , chemotherapy , mobilization , plerixafor , autologous stem cell transplantation , hematopoietic stem cell transplantation , surgery , lymphoma , apheresis , transplantation , gastroenterology , oncology , chemokine , receptor , archaeology , cxcr4 , history , platelet
Background High‐dose chemotherapy supported by autologous stem cell transplantation ( ASCT ) is an effective treatment for patients with lymphomas. However, failure to reach the minimum threshold of hematopoietic stem cells to proceed to ASCT may occur, even with the most effective strategies currently available. Study Design and Methods We report on 33 patients diagnosed with lymphoma who had at least one prior mobilization failure and received cytarabine at a dose of 400 mg/m 2 /day intravenously × 3 days plus granulocyte–colony‐stimulating factor ( G ‐ CSF ) 10 to 12 μg/kg/day as mobilization regimen. The median number of previous lines of chemotherapy was three. Results Thirty‐two of 33 patients (96.8%) reached the target CD 34+ cell dose (>2 × 10 6 /kg). The mean (range) number of apheresis procedures was 1.8 (1‐3) with 4.69 × 10 6 (1.5 × 10 6 ‐6.8 × 10 6 )/kg CD 34+ cells obtained. All but one patient received chemomobilization in the outpatient department. Severe infections or treatment‐related mortality were not observed. All patients that received ASCT (31/33) engrafted without requiring G ‐ CSF during the posttransplant period. Conclusion This study shows that cytarabine at intermediate doses plus G ‐ CSF in patients diagnosed with lymphoma who had a prior mobilization failure is a feasible and effective mobilization regimen.