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

Shin Young Hyun, June Won Cheong, Soo Jeong Kim, Yoo Hong Min, Deok Hwan Yang, Jae Sook Ahn, Won Sik Lee, Hun Mo Ryoo, Young Rok Do, Ho Sup Lee, Jae Hoon Lee, Sung Yong Oh, Cheolwon Suh, Ho Young Yhim, Jin Seok Kim

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14 Citations (Scopus)

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× 106 cells/kg) than HD cyclophosphamide (4.44× 106 cells/kg) or platinum-based chemotherapies (6.08× 106 cells/kg, P < .001). The rate of successful mobilization (CD34+ cell count ≥5.0× 106 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.

Original languageEnglish
Pages (from-to)73-79
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

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All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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