Successful mobilization of peripheral blood stem cells with theDHAP regimen (dexamethasone, cytarabine, cisplatinum) plusgranulocyte colony-stimulating factor in patients with relapsedHodgkin's disease
2005
High-dose chemotherapy followed by autologous stem cell
transplantation can improve the outcome of relapsed and
refractory Hodgkins disease (HD) patients. The objective of the
trial was to determine the mobilizing potential of the DHAP
salvage regimen (dexamethasone, cytarabine, cisplatin) for the
collection of peripheral blood stem cells (PBSC) in patients
with relapsed HD. The target yield of harvesting CD34 + cells
was more or = 2 x 10(6)/kg in order to support the subsequent
myeloablative chemotherapy. Most of the 105 patients included
were intensively pre-treated with different combination
chemotherapy regimens prior to mobilization. The use of DHAP
followed by granulocyte colony-stimulating factor (G-CSF; 10
microg/kg) resulted in the successful collection of adequate
numbers of PBSC in 97.1% of patients (102 of 105) with a median
harvest of CD34+ cells of 13 x 10(6)/kg (range 2.6 - 85.1).
More than 2.0 x 10(6) CD34+ cells/kg were achieved in 65 of 103
(63%) patients after 1 apheresis, the maximum number of
aphereses for all patients was 3. It was found that the optimal
time of PBSC harvest was at days 13 - 16 after initiating the
mobilization regimen. These results demonstrate that the
salvage chemotherapy regimen, such as DHAP combined with G-CSF,
can be successfully used to mobilize PBSC in HD patients.
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