TY - JOUR
T1 - Treatment with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone combined with cytarabine and methotrexate results in poor mobilization of peripheral blood stem cells in patients with mantle cell lymphoma
AU - Hill, Brian T.
AU - Rybicki, Lisa
AU - Smith, Stephen
AU - Dean, Robert
AU - Kalaycio, Matt
AU - Pohlman, Brad
AU - Sweetenham, John
AU - Tench, Shawnda
AU - Sobecks, Ronald
AU - Andresen, Steven
AU - Copelan, Edward
AU - Bolwell, Brian J.
PY - 2011/6
Y1 - 2011/6
N2 - Hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone combined with cytarabine and methotrexate) is an intense chemotherapy regimen frequently used for hematologic malignancies including mantle cell lymphoma. To address whether treatment with hyper-CVAD impairs mobilization of peripheral blood stem cells, we retrospectively analyzed mobilization data from 77 consecutive adult patients with mantle cell lymphoma who underwent peripheral blood stem cell (PBSC) mobilization for planned autologous stem cell transplant (ASCT). Compared to patients treated with alternative regimens, patients treated with hyper-CVAD collected fewer CD34+ cells, required more total days of pheresis, and more frequently required a second mobilization attempt, despite being more likely to have undergone mobilization with a VP16-containing regimen. In multivariable linear regression analysis, treatment with hyper-CVAD was associated with a significant reduction in total CD34+ cells mobilized (p < 0.001). These findings suggest that alternative mobilizing strategies prior to ASCT are needed for patients with mantle cell lymphoma who have received hyper-CVAD.
AB - Hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone combined with cytarabine and methotrexate) is an intense chemotherapy regimen frequently used for hematologic malignancies including mantle cell lymphoma. To address whether treatment with hyper-CVAD impairs mobilization of peripheral blood stem cells, we retrospectively analyzed mobilization data from 77 consecutive adult patients with mantle cell lymphoma who underwent peripheral blood stem cell (PBSC) mobilization for planned autologous stem cell transplant (ASCT). Compared to patients treated with alternative regimens, patients treated with hyper-CVAD collected fewer CD34+ cells, required more total days of pheresis, and more frequently required a second mobilization attempt, despite being more likely to have undergone mobilization with a VP16-containing regimen. In multivariable linear regression analysis, treatment with hyper-CVAD was associated with a significant reduction in total CD34+ cells mobilized (p < 0.001). These findings suggest that alternative mobilizing strategies prior to ASCT are needed for patients with mantle cell lymphoma who have received hyper-CVAD.
KW - Mantle cell lymphoma
KW - autologous stem cell transplant
KW - hyper-CVAD
KW - mobilization
UR - http://www.scopus.com/inward/record.url?scp=79957510429&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79957510429&partnerID=8YFLogxK
U2 - 10.3109/10428194.2010.551154
DO - 10.3109/10428194.2010.551154
M3 - Article
C2 - 21314484
AN - SCOPUS:79957510429
SN - 1042-8194
VL - 52
SP - 986
EP - 993
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 6
ER -