Background and Objectives. The aim of this study was to evaluate the efficacy of pegfilgrastim, in combination with salvage chemotherapy, in mobilizing CD34+ stem cells into the peripheral blood of pretreated lymphoma patients. Design and Methods. This was an open-label phase II study including 25 pretreated patients (Hodgkin's disease=4; aggressive non-Hodgkin's lymphoma=21). The primary end-point of the study was the successful mobilization of a target cell dose of 2×106 CD34+ cells/kg in lymphoma patients receiving ifosfamide, epirubicin and etoposide (IEV) chemotherapy and a fixed dose (6 mg) of pegfilgrastim given as single subcutaneous injection. Results. Following chemotherapy, all patients had grade 4 neutropenia that lasted a median of 1.5 days (1-3). Pegfilgrastim treatment was well tolerated and only 2/25 patients required pain-control medication. CD34+ cells were mobilized in all patients. The median (range) peak value of peripheral blood CD34+ cells after IEV chemotherapy and pegfilgrastim was 141×106/L (12.8-386) and occurred almost invariably on day +14 (13-16). Twenty-three of the 25 patients underwent a single standard volume leukapheresis to collect a median of 8.7×10 6 CD34+ cells/kg (1.78-17.3). Twenty four/25 patients (96%) reached the target cell dose of 2×106 CD34+ cells/kg. High concentrations of circulating CD34+ cells (> 50×106/L) were observed for several days after the achievement of the peak value. All the study patients were transplanted with their pegfilgrastim-mobilized CD34+ cells and showed a rapid and sustained engraftment after high-dose chemotherapy. Interpretation and Conclusions. Our results show that pegfilgrastim as an adjunct to chemotherapy is a predictable and highly effective mobilization regimen in pretreated lymphoma patients.
|Number of pages||7|
|Publication status||Published - Feb 2005|
- Autologous stem cell transplantation
- CD34 cells
ASJC Scopus subject areas