Abstract
BackgroundThe regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is an efficient treatment of non-Hodgkin’s lymphoma (NHL). This study aimed to assess the efficacy and toxicity of dose-adjusted CHOP alone or in combination with rituximab (R-CHOP) by examining the stem cell mobilization in NHL patients. Factors affecting the collection of CD34+ cells were also explored.MethodsOur retrospective study included 39 patients eligible for autologous stem cell transplantation: 14 patients who expressed CD20 and were financially eligible received R-CHOP for autologous peripheral blood stem cell (APBSC) mobilization; the remaining 25 patients received CHOP.ResultsThe median CD34+ cell yield was 7.01 × 106 cells/kg body weight (range 1.49–28.39 × 106 cells/kg body weight), with only two patients failing to meet the target CD34+ cell harvest of ≥2.0 × 106 cells/kg body weight. The median number of apheresis procedures per patient was 1 (range 1–3). The APBSC mobilization yield of the CHOP group appeared to be higher than that of the R-CHOP group (P = 0.005), whereas the success rate was similar between groups. R-CHOP elevated the complete response (CR) rate in B cell lymphoma patients as compared with CHOP (P = 0.01). No significant differences in toxicity or engraftment were observed between the two groups.ConclusionThe present study demonstrated that dose-adjusted CHOP chemotherapy effectively mobilized APBSCs in NHL patients and that the addition of rituximab to dose-adjusted CHOP chemotherapy elevated the CR rate for patients with B-cell lymphoma.
Highlights
The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is an efficient treatment of non-Hodgkin’s lymphoma (NHL)
CHOP or CHOP-like regimens were administered for autologous peripheral blood stem cell (APBSC) mobilization
The R-CHOP and CHOP groups were well matched in terms of age, sex, Ann Arborstage, age-adjusted international prognostic index, previous chemotherapy cycles, and disease status at mobilization (Table 1)
Summary
The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is an efficient treatment of non-Hodgkin’s lymphoma (NHL). This study aimed to assess the efficacy and toxicity of dose-adjusted CHOP alone or in combination with rituximab (R-CHOP) by examining the stem cell mobilization in NHL patients. Autologous stem cell transplantation (ASCT) provides hematopoietic support after high-dose chemotherapy. Additional study is required to determine the optimal mobilization regimen in terms of safety, progenitor yield, engraftment, and contamination with tumor cells [3]. All current regimens fail to mobilize a sufficient number of hematopoietic stem cells to proceed to transplantation in 5–40% of patients [1, 2, 5], and some patients relapse after ASCT due to residual disease after high-dose chemotherapy or contamination of the mobilization product with tumor cells [6, 7]. Additional research is required to determine a more effective mobilization regimen to improve patients’ outcome and survival
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