Treatment with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone combined with cytarabine and methotrexate results in poor mobilization of peripheral blood stem cells in patients with mantle cell lymphoma

Brian T. Hill, Lisa Rybicki, Stephen Smith, Robert Dean, Matt Kalaycio, Brad Pohlman, John Sweetenham, Shawnda Tench, Ronald Sobecks, Steven Andresen, Edward Copelan, Brian J. Bolwell

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone combined with cytarabine and methotrexate) is an intense chemotherapy regimen frequently used for hematologic malignancies including mantle cell lymphoma. To address whether treatment with hyper-CVAD impairs mobilization of peripheral blood stem cells, we retrospectively analyzed mobilization data from 77 consecutive adult patients with mantle cell lymphoma who underwent peripheral blood stem cell (PBSC) mobilization for planned autologous stem cell transplant (ASCT). Compared to patients treated with alternative regimens, patients treated with hyper-CVAD collected fewer CD34+ cells, required more total days of pheresis, and more frequently required a second mobilization attempt, despite being more likely to have undergone mobilization with a VP16-containing regimen. In multivariable linear regression analysis, treatment with hyper-CVAD was associated with a significant reduction in total CD34+ cells mobilized (p < 0.001). These findings suggest that alternative mobilizing strategies prior to ASCT are needed for patients with mantle cell lymphoma who have received hyper-CVAD.

Original languageEnglish (US)
Pages (from-to)986-993
Number of pages8
JournalLeukemia and Lymphoma
Volume52
Issue number6
DOIs
StatePublished - Jun 1 2011

Keywords

  • Mantle cell lymphoma
  • autologous stem cell transplant
  • hyper-CVAD
  • mobilization

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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