Contributions
Abstract: PB2456
Type: Publication Only
Background
currently high-dose chemotherapy with autologous hematopoietic stem cell transplantation is the standard of treatment for patients with Hodgkin's Lymphoma (HL) who has the first chemosensitive relapse of the disease. At our center, most of the patients with HL are mobilized PBSC when they achieve complete or partial remission after the first line of therapy to have adequate stem cells reserve in case of autologous transplantation. There are many studies devoted to the non-myelosuppressive regimens of mobilization with vinorelbine in patients with multiple myeloma, who showed its efficacy, low toxicity and reduced costs for the preparation of PBSC. Therefore, our center performed study for adaptation of this regimen in patients with other hematological malignancies, like HL. We present a comparison of mobilization regimens using vinorelbine at dose 35 mg/m2 and cyclophosphamide at dose 1.5 g/m2 in homogeneous groups of patients with HL in remission after the first line of chemotherapy.
Aims
To assess the efficacy of mobilization with vinorelbine in patients with HL.
Methods
We have analyzed the data of 18 patients with HL, with similar parameters of the median age and status of the disease, in the complete remission who received first line of therapy and underwent PBSC mobilization. Patients were divided into 2 groups according to the mobilization regimens: group 1 - vinorelbine (n = 6), group 2 - cyclophosphamide (n = 12). In group 1, the following scheme was used: Day 1 - vinorelbine 35 mg/m2, IV; from Day 4 - filgrastim 10 mg/kg, SC daily. In group 2: Day 1 - cyclophosphamide 1.5 mg/kg, IV; from Day 2 - filgrastim 10 mg/kg SC, daily. The first day of apheresis was initiated at CD34+ cells level of more than 20/μL in peripheral blood.
Results
The median of CD34+ cells in peripheral blood (PB) on the first day of harvest was: 193.5/μL in group 1 and 105/μL in group 2. On the first day of harvest, adequate number of PBSC (>2.0x106/kg) was achieved in 100% of patients in group 1 (range 2.4-7.1x106/kg, the median 4.85x106/kg) and 50% patients from group 2 (range 0.7-7.0x106/kg, the median 2.89x106/kg). There were need from 1 to 3 harvest (the median 1.5) in order to yield the minimum amount of CD34+ in group 2 patients. The length of hospital stay for patients in group 1 was 9-10 days (median 9), and 9 to 13 days (median 11) for group 2. Neutropenia grade 4 developed in 33% of patients in group 2 and was not noted in any patient in group 1. Significant differences were found between the harvests (p=0.04) and days in hospital (p=0.009) between groups 1 and 2. The number of CD34+ cell/kg harvested in first day had tendency (p=0.06) favor to vinorelbine. There were no statistically significant differences between the groups of patients according to the level of CD34+ cells in the PB on the first day of harvest, the number of CD34+ cells/kg collected on the first day of harvest and the total number of collected CD34+ cells/kg.
Conclusion
Our results demonstrate that vinorelbine for PBSC mobilization i has comparable efficacy with intermediate doses of cyclophosphamide in patients with HL. At the same time, less hospital days and the number of harvest makes this regimen more cost attractive.
Continuation of study vinorelbine in mobilization in hematolgical patients will reduce the frequency of "waste harvest", the costs of collection PBSC and the risk of complications.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous peripheral blood stem cell tansplantati, Hodgkin's Lymphoma, Mobilization, Stem cell collection
Abstract: PB2456
Type: Publication Only
Background
currently high-dose chemotherapy with autologous hematopoietic stem cell transplantation is the standard of treatment for patients with Hodgkin's Lymphoma (HL) who has the first chemosensitive relapse of the disease. At our center, most of the patients with HL are mobilized PBSC when they achieve complete or partial remission after the first line of therapy to have adequate stem cells reserve in case of autologous transplantation. There are many studies devoted to the non-myelosuppressive regimens of mobilization with vinorelbine in patients with multiple myeloma, who showed its efficacy, low toxicity and reduced costs for the preparation of PBSC. Therefore, our center performed study for adaptation of this regimen in patients with other hematological malignancies, like HL. We present a comparison of mobilization regimens using vinorelbine at dose 35 mg/m2 and cyclophosphamide at dose 1.5 g/m2 in homogeneous groups of patients with HL in remission after the first line of chemotherapy.
Aims
To assess the efficacy of mobilization with vinorelbine in patients with HL.
Methods
We have analyzed the data of 18 patients with HL, with similar parameters of the median age and status of the disease, in the complete remission who received first line of therapy and underwent PBSC mobilization. Patients were divided into 2 groups according to the mobilization regimens: group 1 - vinorelbine (n = 6), group 2 - cyclophosphamide (n = 12). In group 1, the following scheme was used: Day 1 - vinorelbine 35 mg/m2, IV; from Day 4 - filgrastim 10 mg/kg, SC daily. In group 2: Day 1 - cyclophosphamide 1.5 mg/kg, IV; from Day 2 - filgrastim 10 mg/kg SC, daily. The first day of apheresis was initiated at CD34+ cells level of more than 20/μL in peripheral blood.
Results
The median of CD34+ cells in peripheral blood (PB) on the first day of harvest was: 193.5/μL in group 1 and 105/μL in group 2. On the first day of harvest, adequate number of PBSC (>2.0x106/kg) was achieved in 100% of patients in group 1 (range 2.4-7.1x106/kg, the median 4.85x106/kg) and 50% patients from group 2 (range 0.7-7.0x106/kg, the median 2.89x106/kg). There were need from 1 to 3 harvest (the median 1.5) in order to yield the minimum amount of CD34+ in group 2 patients. The length of hospital stay for patients in group 1 was 9-10 days (median 9), and 9 to 13 days (median 11) for group 2. Neutropenia grade 4 developed in 33% of patients in group 2 and was not noted in any patient in group 1. Significant differences were found between the harvests (p=0.04) and days in hospital (p=0.009) between groups 1 and 2. The number of CD34+ cell/kg harvested in first day had tendency (p=0.06) favor to vinorelbine. There were no statistically significant differences between the groups of patients according to the level of CD34+ cells in the PB on the first day of harvest, the number of CD34+ cells/kg collected on the first day of harvest and the total number of collected CD34+ cells/kg.
Conclusion
Our results demonstrate that vinorelbine for PBSC mobilization i has comparable efficacy with intermediate doses of cyclophosphamide in patients with HL. At the same time, less hospital days and the number of harvest makes this regimen more cost attractive.
Continuation of study vinorelbine in mobilization in hematolgical patients will reduce the frequency of "waste harvest", the costs of collection PBSC and the risk of complications.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous peripheral blood stem cell tansplantati, Hodgkin's Lymphoma, Mobilization, Stem cell collection