High-dose Therapy and Autografting with Mobilized Peripheral Blood Progenitor Cells in Patients with Malignant Lymphoma

Abstract

In this report we present the data of 100 patients who were autografted with peripheral blood progenitor cells (PBPC) following high-dose conditioning therapy. Fifty-six patients were male and 44 were female with a median age of 36 years (range 19–58). Thirty-five patients had Hodgkin’s disease and 65 non-Hodgkin lymphoma (NHL). PBPC were collected either following the administration of recombinant human GM-CSF or G-CSF during steady-state hematopoiesis or during cytokine-enhanced recovery after cytotoxic chemotherapy. Seven patients were autografted using PBPC harvested post-chemotherapy without cytokine support. At the time of PBPC mobilization 21 patients had bone marrow involvement by histopathological examination. The high-dose preparatory regimens were either BEAM (BCNU, etoposide, cytosine arabinoside, melphalan), CBV (cyclophosphamide, BCNU, etoposide), or a combination of total body irradiation (TBI) and cyclophosphamide. In 92 patients hematological reconstitution was evaluable. The median time to reach a neutrophil count ≥ 0.5 × 109/l was 14 days (range 9–69) and an unsubstituted platelet count > 20 × 109/l was observed after a median of 12 days (range 6–205). Seven patients died of transplant-related toxicity. Twenty-seven patients relapsed or had further tumor progression after a median time of 5 months (range 1–49) post-transplantation. With a median follow-up of 14 months (range 1–64), 66 patients are alive in unmaintained remission. There is no evidence for late graft failure. These data reflect the ability of blood-derived hematopoietic progenitor cells to restore long-term hematopoiesis after myeloablative therapy without additional bone marrow support.KeywordsTotal Body IrradiationBone Marrow InvolvementPeripheral Blood Progenitor CellTotal Nucleate CellMyeloablative TherapyThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.