High-Dose Etoposide Plus Granulocyte Colony-Stimulating Factor as an Effective Chemomobilization Regimen for Autologous Stem Cell Transplantation in Patients with Non-Hodgkin Lymphoma Previously Treated with CHOP-based Chemotherapy: A Study from the Consortium for Improving Survival of Lymphoma
- Authors
- Hyun, Shin Young; Cheong, June-Won; Kim, Soo-Jeong; Min, Yoo Hong; Yang, Deok-Hwan; Ahn, Jae-Sook; Lee, Won-Sik; Ryoo, Hun-Mo; Do, Young Rok; Lee, Ho Sup; Lee, Jae Hoon; Oh, Sung Yong; Suh, Cheolwon; Yhim, Ho-Young; Kim, Jin Seok
- Issue Date
- Jan-2014
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- Cyclophosphamide; Etoposide; Platinum; Stem cell mobilization; Non-Hodgkin lymphoma
- Citation
- BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, v.20, no.1, pp.73 - 79
- Journal Title
- BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
- Volume
- 20
- Number
- 1
- Start Page
- 73
- End Page
- 79
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/12920
- DOI
- 10.1016/j.bbmt.2013.10.012
- ISSN
- 1083-8791
- Abstract
- We conducted a multicenter retrospective study to compare the efficacy and toxicity of various chemomobilization regimens: high-dose (HD) cyclophosphamide, HD etoposide (VP-16), and platinum-based chemotherapies. We reviewed the experiences of 10 institutions with 103 non-Hodgkin lymphoma patients who had previously only been treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)based chemotherapy. The mobilization yields for each regimen were analyzed. HD VP-16 mobilized a significantly higher median number of CD34(+) cells (16.22 x 10(6) cells/kg) than HD cyclophosphamide (4.44 x 10(6) cells/kg) or platinum-based chemotherapies (6.08 x 10(6) cells/kg, P < .001). The rate of successful mobilization (CD34(+) cell count >= 5.0 x 10(6) cells/kg) was also significantly higher for HD VP-16 (86%) than for HD cyclophosphamide (45%) or platinum-based chemotherapies (61%, P = .004). The successful mobilization rate on day 1 of 72% for HD VP-16 was significantly higher than the rates for HD cyclophosphamide (13%) and platinum-based chemotherapies (26%, P < .001). In multivariate analysis, HD VP-16 was a significant predictor of successful mobilization (P = .014; odds ratio, 5.25; 95% confidence interval, 1.40 to 19.63). Neutropenic fever occurred in 67% of patients treated with HD VP-16. The incidence was similar for HD cyclophosphamide (58%, P = .454) but was significantly lower for platinum-based chemotherapies (12%, P < .001). However, fatal (grade >= 4) infection and treatment-related mortality were not observed in this study. In conclusion, the mobilization yield was significantly influenced by the chemomobilization regimen, and HD VP-16 was a highly effective mobilization regimen in patients with non-Hodgkin lymphoma. (C) 2014 American Society for Blood and Marrow Transplantation.
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