Efficacy and safety of stem cell mobilization following gemcitabine, dexamethasone, cisplatin (GDP) salvage chemotherapy in patients with relapsed or refractory lymphoma.
Catherine TangOsvaldo Espin-GarciaAnca PricaVishal KurkretiRobert KridelArmand KeatingChristopher J PatriquinJohn KuruvillaMichael CrumpPublished in: Leukemia & lymphoma (2020)
High-dose chemotherapy and autologous stem cell transplant (ASCT) remains a cornerstone of treatment in relapsed/refractory (R/R) aggressive-histology lymphomas. This retrospective study examined efficacy and safety of peripheral blood stem cell (PBSC) mobilization using cyclophosphamide/etoposide and GCSF (CE + GCSF, n = 129) versus gemcitabine, dexamethasone and cisplatin and GCSF (GDP + GCSF, n = 210). All patients received first salvage with GDP. Patients mobilized with CE + GCSF required fewer days of leukapheresis (median 1 vs 2 day; p = .001) and achieved higher total CD34+ yield than GDP + GCSF patients (8.5 vs 7.1 × 106 CD34+ cells/kg, p = .001). Rates of febrile neutropenia and CD34+ collection ≥5 × 106 CD34+ cells/kg were similar (OR 1.19, 95% CI: 0.54-2.6, p = .66). In multivariable analysis, days to engraftment and admission duration were not statistically different between the two mobilization strategies. While CE + GCSF appeared more efficacious for mobilization after GDP salvage, this did not translate to significant differences in clinical outcomes.
Keyphrases
- stem cells
- high dose
- end stage renal disease
- chronic kidney disease
- newly diagnosed
- peripheral blood
- low dose
- ejection fraction
- prognostic factors
- peritoneal dialysis
- induced apoptosis
- diffuse large b cell lymphoma
- acute myeloid leukemia
- acute lymphoblastic leukemia
- emergency department
- locally advanced
- patient reported outcomes
- multiple myeloma
- mesenchymal stem cells
- cell therapy
- cord blood
- endoplasmic reticulum stress
- data analysis