Effect of prior chemotherapy on hematopoietic stem cell mobilization

Abstract

Summary:A number of studies have suggested that prior chemotherapy correlates negatively with the efficiency of hematopoietic stem cell mobilization. However, little data exist with regard to the relative effects of the specific chemotherapeutic drug classes. We retrospectively reviewed the records of 201 consecutive patients with nonmyeloid malignancies undergoing CD34 þ cell mobilization with chemotherapy þ granulocyte colony-stimulating factor (G-CSF). The number of prior chemotherapy courses correlated negatively with the peripheral CD34 þ cell concentration (pCD34) on the first day of collection (Po0.001). No significant correlation was found for age, gender, tumor primary, mobilization chemotherapy regimen, disease status, marrow involvement, prior radiation therapy, or dose and timing of G-CSF administration. When the number of courses of individual classes of chemotherapeutic agents was correlated with pCD34, only exposures to platinum compounds (P ¼ 0.001) and alkylating agents (P ¼ 0.01) were found to be independent negative predictive factors for pCD34. Within classes, DNA crosslinking agents and etoposide appeared possibly more damaging than DNA methylating agents and doxorubicin, respectively. None of the drug classes showed evidence of recovery. We conclude that exposure to chemotherapy, especially platinum compounds and alkylating agents, should be minimized prior to mobilization.

An analysis of the optimal timing of peripheral blood stem cell harvesting following priming with cyclophosphamide and G-CSF

“…[20][21][22] In our series, only an increased number of lines of previous therapy was a significant risk factor for harvesting failure.…”

ESHAP+fixed dose G-CSF as autologous peripheral blood stem cell mobilization regimen in patients with relapsed or refractory diffuse large cell and Hodgkin's lymphoma: a single institution result of 127 patients

“…Stem cell collection may be influenced by multiple factors such as type of lymphoma, age, stage, type and frequency of previous chemotherapy, radiation therapy (XRT), mobilization regimen and type of apheresis machine. [29][30][31][32][33][34] Most reports had a very diverse group of patients including HD and low, intermediate and high-grade NHL, acute myelogenous leukemia and even some solid cancers. These patients have diverse characteristics with a wide range of variables.…”

Correlation between serum lactate dehydrogenase and stem cell mobilization

“…[1][2][3][4] PBCD34 reflects the extent of mobilization of stem cells from the bone marrow into the blood-and depends upon a number of factors including diagnosis, extent of prior therapy, mobilization technique and type and dose of the growth factor used. 3,[5][6][7][8][9] However, PBCD34 is not always immediately available at the planned time of apheresis. Waiting for a PBCD34 result for a few hours may result in a delayed start or even a missed opportunity for a good stem cell collection.…”