Comparison of peripheral blood progenitor cell yield from standard chemotherapy used in the treatment of lymphoid malignancies and high-dose cyclophosphamide: a retrospective review of 141 patients
Comparison of peripheral blood progenitor cell yield from standard chemotherapy used in the treatment of lymphoid malignancies and high-dose cyclophosphamide: a retrospective review of 141 patients
复制标题
DOI：
10.1111/j.1537-2995.2006.00695.x
复制
发表时间：
2006-02-01
期刊：
影响因子：
2.9
通讯作者：
Laneuville, P
中科院分区：
文献类型：
--
作者：
Assouline, S;Sylvestre, MP;Laneuville, P
背景：外周血祖细胞（PBPC）通常在用高剂量环磷酰胺（HDC）联合生长因子动员后收集。动员PBPC可能不需要HDC，并且淋巴恶性肿瘤患者可以通过化疗治疗方案采集。 研究设计和方法：对141例化疗后采集PBPC的淋巴瘤或多发性骨髓瘤患者进行回顾性分析。比较接受 HDC (n = 51) 和其他化疗方案 (n = 90) 的患者的 PBPC 产量和动员时间，包括高剂量环磷酰胺和依托泊苷（HDC 加 VP-16；n = 41）、CHOP、ESHAP、ABVD、VAD 和其他方案 (n = 49)。多元线性回归模型和比例风险模型分别确定了影响产量和动员时间的因素。 结果：HDC 和所有非 HDC 方案之间的平均产量差异显着，其中 HDC 加 VP-16 的产量最高。 CD34 计数超过 5 x 10(6)/kg 的患者比例在不同方案之间没有显着差异。在多元线性回归模型中，HDC 加 VP-16 比 HDC 产生更高的 PBPC 产量，但所有其他方案都没有。此外，无论采用哪种动员方案，接受过一种以上化疗方案的患者的产量均较低。 HDC 组的平均活动天数为 10.2 天，HDC 加 VP-16 组为 17.1 天，所有其他方案为 14.2 天。动员时间受到比例风险模型中使用的化疗和既往治疗方案数量的影响。结论：这些结果表明，HDC 加 VP-16 的 PBPC 平均产量较高，但用于一线或复发治疗的非 HDC 加 VP-16 方案与 HDC 之间的产量没有差异，表明 HDC 可能是不必要的额外治疗。
BACKGROUND: Peripheral blood progenitor cells (PBPCs) are often collected after mobilization with high-dose cyclophosphamide (HDC) combined with growth factors. HDC may not be needed for PBPC mobilization, and patients with lymphoid malignancies can be harvested with treatment regimens of chemotherapy.STUDY DESIGN AND METHODS: A retrospective analysis was performed on 141 patients with lymphoma or multiple myeloma whose PBPCs were harvested after chemotherapy. The PBPC yield and time to mobilization was compared between patients who received HDC (n = 51) and other chemotherapy regimens (n = 90) including high-dose cyclophosphamide and etoposide (HDC plus VP-16; n = 41), CHOP, ESHAP, ABVD, VAD, and others (n = 49). A multiple linear regression model and proportional hazards model determined factors influencing yield and time to mobilization, respectively.RESULTS: The difference in mean yield between HDC and all non-HDC regimens was significant, with HDC plus VP-16 resulting in the highest yields. The proportion of patients achieving a CD34 count in excess of 5 x 10(6) per kg did not differ significantly between the regimens. In a multiple linear regression model, HDC plus VP-16 resulted in a higher PBPC yield than HDC but all other regimens did not. In addition, patients exposed to more than one prior chemotherapy regimen had lower yield regardless of the mobilization regimen. The mean number of days to mobilization with HDC was 10.2 days, 17.1 days for HDC plus VP-16, and 14.2 days for all other regimens. The timing of mobilization was influenced by the chemotherapy used and the number of prior regimens in a proportional hazards model.CONCLUSION: These results demonstrate a higher mean yield of PBPCs with HDC plus VP-16 but no difference in yield between non-HDC plus VP-16 regimens used for first-line or relapse therapy and HDC, suggesting that HDC may be an unnecessary additional therapy.