Poor mobilization is an independent prognostic factor in patients with malignant lymphomas treated by peripheral blood stem cell transplantation

Bone Marrow Transplant. 2006 Apr;37(8):719-24. doi: 10.1038/sj.bmt.1705298.

Abstract

Haemopoietic stem cell therapy is an increasingly adopted procedure in the treatment of patients with malignant lymphoma. In this retrospective analysis, we evaluated 262 patients, 57 (22%) with Hodgkin's and 205 (78%) with non-Hodgkin's lymphomas (NHL), and 665 harvesting procedures in order to assess the impact of poor mobilization on survival and to determine the factors that may be predictive of CD34(+) poor mobilization. The mobilization chemotherapy regimens consisted of high-dose cyclophosphamide in 92 patients (35.1%) and a high-dose cytarabine-containing regimen (DHAP in 87 patients -(33.2%), MAD in 83 (31.7%)). The incidence of poor mobilizers (<2 x 10(6) CD34(+) cells/kg) was 17.9% overall, with a 10% of very poor mobilizers (< or = 1 x 10(6)/kg). Refractory disease status and chemotherapeutic load (>3 regimens) before mobilization played a negative role and were associated with poor mobilization. Survival analysis of all harvested patients showed an overall survival at 3 years of 71% in good mobilizers vs 33% in poor mobilizers (P=0.002). The event-free survival at 3 years was 23% in poor mobilizers and 58% in good mobilizers (P=0.04). We conclude that in NHL patients, poor mobilization status is predictive of survival.

MeSH terms

  • Adult
  • Antigens, CD34 / biosynthesis
  • Antineoplastic Agents / therapeutic use
  • Disease-Free Survival
  • Female
  • Flow Cytometry
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Lymphoma / metabolism
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Models, Statistical
  • Multivariate Analysis
  • Peripheral Blood Stem Cell Transplantation / methods*
  • Prognosis
  • Retrospective Studies
  • Stem Cells / metabolism
  • Time Factors
  • Treatment Outcome

Substances

  • Antigens, CD34
  • Antineoplastic Agents