Factors affecting autologous peripheral blood stem cell collection in patients with relapsed or refractory diffuse large cell lymphoma and Hodgkin lymphoma: A single institution result of 168 patients

Abstract

From 1996 to April 2006, 174 consecutive patients with relapsed or refractory diffuse large cell lymphoma (DLCL) and Hodgkin lymphoma (HL) received ESHAP as salvage and for mobilisation. Males 92, females 76. DLCL 64: HL 104, prior radiation in 35%. First relapse 45%, second relapse 12%, induction failure 43%. Median prior chemotherapy cycles were 6. Median age at apheresis was 26.5 years. Six patients failed mobilisation and 21 patients had CD34+ cells collection <2×10⁶/kg on first apheresis. Median CD34+ cells/kg collection was 5.5×10⁶/kg for first apheresis and 6.7×10⁶/kg for all apheresis. We evaluated impact of histology, gender, age, stage, marrow involvement, prior radiation and chemotherapy cycles, timing (relapse1: relapse > 1: refractory), platelet count and weight. For first apheresis collection; all patients, younger age (p = 0.004), for DLCL (64), younger age (p = 0.021) and higher platelet count (p = 0.013) and for HL (104), younger age (p = 0.036) and male gender had better CD34+ cells collection. For all apheresis product, for all patients, age (p = 0.001) and no prior radiation therapy (p = 0.051) had better CD34+ cells collection. Higher first harvest CD34+ cells collection also resulted in early neutrophil (p ≤ 0.001) and platelet (p = 0.004) engraftment.

Keywords:

• ESHAP
• non-hodgkin lymphoma
• hodgkin lymphoma
• G-CSF
• CD34+ cells
• stem cell mobilisation