Characterization and Outcome of “Hard to Mobilize” Lymphoma Patients Undergoing Autologous Stem Cell Transplantation

A “hard to mobilize” patient was defined as one in whom ≥ 1 × 106CD 34, cells/kg cannot be obtained after two consecutive large volume aphereses. Forty-four consecutive Hodgkin's and non-Hodgkin's lymphoma patients who underwent autologous peripheral blood stem cell (PBSC) transplant treatment between June 1996 and June 1998 were included in this study. Twenty-one patients (48%) met the definition of “hard to mobilize” (Group I). All the rest of the patients (n=23) were the good mobilizers (Group II). The initial mobilization protocol for most patients was 10 μg/kg of G-CSF alone for both groups. For Group 1. 7/21 (33%) patients were unable to achieve a minimal dose of ≥ 1 × 106 CD34+ cells/kg even after a second mobilization attempt and/or bone marrow (BM) harvest (n=5). Overall. 11/21 (52%) required an additional mobilization and/or BM harvest. Only 3/21 (14%) patients were able to meet the target cell dose of ≥ 2.5×106 CD34+ cells/kg (median of 4 apheresis). In contrast. 87% of Group II achieved the ta...