Impact of frontline fludarabine and cyclophosphamide combined treatment on peripheral blood stem cell mobilization in B-cell chronic lymphocytic leukemia.
Fiche publication
Date publication
janvier 2004
Journal
Blood
Auteurs
Membres identifiés du Cancéropôle Est :
Pr FEUGIER Pierre, Pr DELMER Alain
Tous les auteurs :
Tournilhac O, Cazin B, Leprètre S, Diviné M, Maloum K, Delmer A, Grosbois B, Feugier P, Maloisel F, Villard F, Villemagne B, Bastit D, Belhadj K, Azar N, Michallet M, Manhès G, Travade P
Lien Pubmed
Résumé
Ongoing studies in B-cell chronic lymphocytic leukemia are evaluating autologous peripheral blood stem cell (PBSC) transplantation in first remission following fludarabine therapy. However, fludarabine could impair PBSC harvest. In 38 patients after frontline oral fludarabine and cyclophosphamide (FDR-CY) therapy, we prospectively evaluated steady state filgrastim- or lenograstim-primed PBSC mobilization to collect 2.0 x 106/kg or more CD34 cells. The first mobilization, performed a median of 178 days (range, 69-377 days) from the last FDR-CY course, was unsuccessful in 32 patients. This result was significantly associated with a low platelet count before mobilization but not with age, interval from last FDR-CY course, initial stage, remission status, or other blood parameters. Finally, after 1, 2, and 3 mobilizations in 27, 10, and 1 patients, 2.0 x 106/kg or more CD34 cells were collected in only 12. Explorations of the mechanism of poor mobilization and adaptation of PBSC harvest policies after fludarabine treatment are therefore warranted.
Mots clés
Adult, Aged, Antigens, CD34, metabolism, Antineoplastic Combined Chemotherapy Protocols, adverse effects, Cyclophosphamide, adverse effects, Female, Hematopoietic Stem Cell Mobilization, methods, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Lymphocytic, Chronic, B-Cell, blood, Male, Middle Aged, Platelet Count, Transplantation, Autologous, Vidarabine, adverse effects
Référence
Blood. 2004 Jan;103(1):363-5