Intermediate doses of cytarabine plus granulocyte-colony-stimulating factor as an effective and safe regimen for hematopoietic stem cell collection in lymphoma patients with prior mobilization failure

BackgroundHigh-dose chemotherapy supported by autologous stem cell transplantation (ASCT) is an effective treatment for patients with lymphomas. However, failure to reach the minimum threshold of hematopoietic stem cells to proceed to ASCT may occur, even with the most effective strategies currently available. Study Design and MethodsWe report on 33 patients diagnosed with lymphoma who had at least one prior mobilization failure and received cytarabine at a dose of 400mg/m(2)/day intravenouslyx3 days plus granulocyte-colony-stimulating factor (G-CSF) 10 to 12g/kg/day as mobilization regimen. The median number of previous lines of chemotherapy was three. ResultsThirty-two of 33 patients (96.8%) reached the target CD34+ cell dose (>2x10(6)/kg). The mean (range) number of apheresis procedures was 1.8 (1-3) with 4.69x10(6) (1.5x10(6)-6.8x10(6))/kg CD34+ cells obtained. All but one patient received chemomobilization in the outpatient department. Severe infections or treatment-related mortality were not observed. All patients that received ASCT (31/33) engrafted without requiring G-CSF during the posttransplant period. ConclusionThis study shows that cytarabine at intermediate doses plus G-CSF in patients diagnosed with lymphoma who had a prior mobilization failure is a feasible and effective mobilization regimen.