Efficient mobilization of PBSC with vinorelbine/G-CSF in patients with malignant lymphoma

Heizmann, Marc; O'Meara, Alix; Moosmann, Peter; Heijnen, Ingmar; Zuberbühler, M; Fernández, Paula; Burger, Jan A.; Huber, Andreas; Wernli, Martin; Bargetzi, Mario

doi:10.1038/bmt.2008.434

Cited by 16 publications

(10 citation statements)

References 14 publications

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“…31 Others have reported success with alternate CM strategies 13, 16 , including a study showing that 87% (N=39/45) of patients collected ≥2 ×10 6 CD34 + cells/kg using a vinorelbine/GCSF approach. 14 Our study, as well as Wood and colleagues, reported CM collection totals higher than the phase III study with GCSF alone (median 1.98; range 0–15) and G+P (median 5.69; range 0–29). 4 Two studies have compared front line CM vs. G+P.…”

Section: Discussionsupporting

confidence: 52%

A single center’s experience using four different front line mobilization strategies in lymphoma patients planned to undergo autologous hematopoietic cell transplantation

Haverkos¹,

Huang

Elder

et al. 2017

Bone Marrow Transplant

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In an otherwise eligible patient with relapsed lymphoma, inadequate mobilization of peripheral blood stem cells is a limiting factor to proceeding with an autologous hematopoietic cell transplantation (auto-HCT). Multiple strategies have been used to mobilize an adequate number of hematopoietic stem cells (HSCs) with no obvious front-line strategy. We report a single institutional experience mobilizing HSCs using four different approaches in lymphoma patients. We prospectively collected mobilization outcomes on patients planning to undergo auto-HCT at Ohio State University. We report results of first mobilization attempt for all relapsed or refractory lymphoma patients between 2008–2014. We identified 255 lymphoma patients who underwent mobilization for planned auto-HCT. The 255 lymphoma patients underwent the following front line mobilization strategies: 95 (37%) GCSF alone, 38 (15%) chemomobilization (GCSF+chemotherapy), 97 (38%) preemptive day 4 plerixafor, and 25 (10%) rescue day 5 plerixafor. As expected, there were significant differences between cohorts including age, comorbid indices, histology, and amount of prior chemotherapy. After controlling for differences between groups, the odds of collecting 2×106/kg HSCs on the first day of collection and 5×106/kg HSCs in total was highest in the cohort undergoing chemomobilization. In conclusion, our experience highlights the effectiveness of chemomobilization.

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Section: Discussionsupporting

confidence: 52%

A single center’s experience using four different front line mobilization strategies in lymphoma patients planned to undergo autologous hematopoietic cell transplantation

Haverkos¹,

Huang

Elder

et al. 2017

Bone Marrow Transplant

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“…4 Heizmann and colleagues investigated the use of vinorelbine with G-CSF and found that 96% of patients successfully collected sufficient stem cells for ASCT, with a median yield of 3.6 × 10 6 CD34 cells. 5 Copelan et al found that 50/55 patients who received full dose etoposide (2g/m 2 ) and G-CSF with or without rituximab as part of a prospective study collected at least 2 × 10 6 CD34 cells and proceeded to ASCT. 6 A larger, retrospective, multi-institutional analysis showed that in comparison to patients receiving G-CSF alone, patients who received etoposide 2g/m 2 in addition to G-CSF had a higher CD34 cell yield ( 9.34 × 10 6 vs. 3.83 × 10 6 ) and a higher rate of adequate collection after 2 days (42% vs 16%).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of etoposide chemomobilization in lymphoma patients undergoing auto-SCT

Wood

Whitley

et al. 2012

Bone Marrow Transplant

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The effectiveness of stem cell mobilization with granulocyte colony-stimulating factor (G-CSF) in lymphoma patients is suboptimal. We reviewed our institutional experience using chemomobilization with etoposide (VP-16; 375mg/m2 on days +1 and +2) and G-CSF (5ug/kg twice daily from day +3 through the final day of collection) in 159 patients with lymphoma. This approach resulted in successful mobilization (> 2 × 106 CD34 cells collected) in 94% of patients (83% within 4 apheresis sessions). 57% of patients collected at least 5 × 106 cells in ≤ 2 days and were defined as good mobilizers. The regimen was safe with a low rate of rehospitalization. Average costs were $14,923 for good mobilizers and $27,044 for poor mobilizers (p<0.05). Using our data, we performed a ‘break-even’ analysis that demonstrated that adding two doses of Plerixafor to predicted poor mobilizers at the time of first CD34 count would achieve cost neutrality if the frequency of good mobilizers were to increase by 21%, while the frequency of good mobilizers would need to increase by 25% if three doses of Plerixafor were used. We conclude that chemomobilization with etoposide and G-CSF in patients with lymphoma is effective, with future opportunities for cost-neutral improvement using novel agents.

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“…Furthermore, outpatient administration with one in bolus injection and better predictability of apheresis improve patient comfort and simplify the collection procedure, both in multiple myeloma and in malignant lymphoma. [53][54][55] The use of several cytotoxic combination regimes have also been described, including cisplatin, cytosine arabinoside, dexamethasone (DHAP); ifosfamide, carboplatin and etoposide (ICE); etoposide, methylprednisolone, cytarabine and cisplatin (ESHAP); cyclophosphamide, mitoxantrone, dexamethasone (CMD); dexamethasone, carmustine, etoposide, cytarabine, melphalan (Dexa-BEAM); ifosfamide, epirubicin, etoposide (IEE); cyclophosphamide and etoposide with or without cisplatin; and etoposide and rituximab. …”

Section: Measurement Of Cd34+ Cell Count In Peripheral Bloodmentioning

confidence: 99%

Mobilization of hematopoietic progenitor cells for autologous transportation: consensus recommendations

Duarte

Prado²,

Vieira

et al. 2016

Rev. Assoc. Med. Bras.

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SUMMARY Selected patients with certain hematological malignancies and solid tumors have the potential to achieve long-term survival with autologous hematopoietic progenitor cell transplant. The collection of these cells in peripheral blood avoids multiple bone marrow aspirations, results in faster engraftment and allows treatment of patients with infection, fibrosis, or bone marrow hypocellularity. However, for the procedure to be successful, it is essential to mobilize a sufficient number of progenitor cells from the bone marrow into the blood circulation. Therefore, a group of Brazilian experts met in order to develop recommendations for mobilization strategies adapted to the reality of the Brazilian national health system, which could help minimize the risk of failure, reduce toxicity and improve the allocation of financial resources.

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Efficient mobilization of PBSC with vinorelbine/G-CSF in patients with malignant lymphoma

Cited by 16 publications

References 14 publications

A single center’s experience using four different front line mobilization strategies in lymphoma patients planned to undergo autologous hematopoietic cell transplantation

A single center’s experience using four different front line mobilization strategies in lymphoma patients planned to undergo autologous hematopoietic cell transplantation

Effectiveness of etoposide chemomobilization in lymphoma patients undergoing auto-SCT

Mobilization of hematopoietic progenitor cells for autologous transportation: consensus recommendations

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