Magagnoli M, Sarina B, Balzarotti M, Castagna L, Timofeeva I, Nozza A, Bertuzzi A, Siracusano L, Sinnone M, Santoro A
Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, Italy.
Bone Marrow Transplant. 2001 Nov;28(10):923-7. doi: 10.1038/sj.bmt.1703265.
The mobilizing potential and therapeutic activity of ifosfamide/vinorelbine-containing regimens with G-CSF support were explored in patients with pretreated malignant lymphomas. Ten patients with non-Hodgkin's lymphoma (NHL) received ifosfamide and vinorelbine, and 17 with Hodgkin's disease (HD) received ifosfamide, vinorelbine and gemcitabine (IGEV regimen), as induction chemotherapy before high-dose chemotherapy (HDT) with peripheral blood stem cell (PBSC) support. Most of the patients had been heavily pretreated with various chemotherapy regimens +/- radiotherapy. The target yield was > or =3 x 10(6) CD34+ cells/kg of body weight in order to support the subsequent myeloablative chemotherapy. The optimal PBSC harvest occurred on days 11 and 12, with no difference in CD34+ cell mobilization kinetics between the ifos- famide/vinorelbine and IGEV regimens. The median number of CD34+ cells/kg body weight collected was 10.9 x 10(6) (range 1.76-61.1 x 10(6)). The median total CD34+ cell/microl, CFU-GM and white blood cells (WBC) for all individual collections was 81.5/microl, 10 x 10(4)/kg, and 17 900/microl, respectively. The target yield of CD34+ cells was reached in 24 of 27 patients. Hematological side-effects were acceptable and no treatment-related hospitalizations or toxic deaths occurred. Fifteen patients have so far received high-dose therapy and PBSC reinfusion with rapid engraftment. These results confirm that ifosfamide and vinorelbine-based chemotherapy regimen with G-CSF support can be successfully and safely used to mobilize PBSCs.
在接受过预处理的恶性淋巴瘤患者中，探讨了含异环磷酰胺/长春瑞滨方案联合粒细胞集落刺激因子（G-CSF）支持的动员潜力和治疗活性。10例非霍奇金淋巴瘤（NHL）患者接受了异环磷酰胺和长春瑞滨治疗，17例霍奇金病（HD）患者接受了异环磷酰胺、长春瑞滨和吉西他滨（IGEV方案），作为在接受外周血干细胞（PBSC）支持的大剂量化疗（HDT）之前的诱导化疗。大多数患者此前已接受过多种化疗方案（±放疗）的重度预处理。目标采集量为≥3×10⁶个CD34⁺细胞/kg体重，以支持随后的清髓性化疗。最佳PBSC采集发生在第11天和第12天，异环磷酰胺/长春瑞滨方案与IGEV方案之间的CD34⁺细胞动员动力学无差异。采集的CD34⁺细胞/kg体重中位数为10.9×10⁶（范围为1.76 - 61.1×10⁶）。所有单次采集的CD34⁺细胞/μl、粒-巨噬细胞集落形成单位（CFU-GM）和白细胞（WBC）中位数分别为81.5/μl、10×10⁴/kg和17900/μl。27例患者中有24例达到了CD34⁺细胞的目标采集量。血液学副作用可接受，未发生与治疗相关的住院或毒性死亡。到目前为止，15例患者已接受了大剂量治疗和PBSC回输，且造血迅速恢复。这些结果证实，含异环磷酰胺和长春瑞滨的化疗方案联合G-CSF支持可成功、安全地用于动员PBSC。
