Poor mobilization is an independent prognostic factor in patients with malignant lymphomas treated by peripheral blood stem cell transplantation

Haemopoietic stem cell therapy is an increasingly adopted procedure in the treatment of patients with malignant lymphoma. In this retrospective analysis, we evaluated 262 patients, 57 (22%) with Hodgkin's and 205 (78%) with non-Hodgkin's lymphomas (NHL), and 665 harvesting procedures in order to assess the impact of poor mobilization on survival and to determine the factors that may be predictive of CD34+ poor mobilization. The mobilization chemotherapy regimens consisted of high-dose cyclophosphamide in 92 patients ( 35.1%) and a highdose cytarabine-containing regimen ( DHAP in 87 patients -( 33.2%), MAD in 83 (31.7%)). The incidence of poor mobilizers (< 2 x 10(6) CD34+ cells/ kg) was 17.9% overall, with a 10% of very poor mobilizers ( <= 1 x 10(6)/ kg). Refractory disease status and chemotherapeutic load (> 3 regimens) before mobilization played a negative role and were associated with poor mobilization. Survival analysis of all harvested patients showed an overall survival at 3 years of 71% in good mobilizers vs 33% in poor mobilizers (P = 0.002). The event-free survival at 3 years was 23% in poor mobilizers and 58% in good mobilizers ( P = 0.04). We conclude that in NHL patients, poor mobilization status is predictive of survival.