Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
Department of Clinical Biochemistry, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
Turk J Med Sci. 2021 Apr 30;51(2):685-692. doi: 10.3906/sag-2008-114.
BACKGROUND/AIM: Gemcitabine, dexamethasone and cisplatin (GDP) is a well-established salvage regimen for relapsed and refractory lymphomas. In this study, we aimed to share our experience with the patients who received GDP/R-GDP (rituximab-gemcitabine, dexamethasone and cisplatin) for stem cell mobilization.
Data of 69 relapsed and refractory Hodgkin lymphoma (HL) and Non-Hodgkin lymphoma (NHL) patients who received GDP/R-GDP as salvage chemotherapy in our center between July 2014 and January 2020 were retrospectively evaluated. After the evaluation of response, 52 patients had a chemosensitive disease and underwent mobilization with GDP/R-GDP plus G–CSF (granulocyte colony-stimulating factor). Collected CD34+ stem cells and related parameters were compared in terms of diagnosis of HL and NHL, early and late stage, patients who did not receive RT and those who received RT, and patients aged under 60 and over 60.
On the 15th day on average (range 11–20), a median number of 8.7 × 106 /kg (4.1–41.5) CD34+ stem cells were collected in 51 (98%) of our 52 chemosensitive patients and 1 (2%) patients failed to mobilize. We observed acceptable hematological and nonhematological toxicity. The targeted amount of 2 × 106 /kg CD34+ stem cells was attained by 98% (n: 51) patients, and all of them underwent autologous stem cell transplantation. Moreover, low toxicity profiles provide outpatient utilization option clinics with close follow-up and adequate supportive care.
We suggest that GDP/R-GDP plus G-CSF can be used as an effective chemotherapy regimen for mobilizing CD34+ stem cells from peripheral blood in relapsed and refractory lymphoma patients due to low toxicity, effective tumor reduction, and successful stem cell mobilization. It can also be assumed that the GDP mobilization regimen may be more effective, especially in patients with early-stage disease and in HL patients.
背景/目的：吉西他滨、地塞米松和顺铂（GDP）是治疗复发和难治性淋巴瘤的成熟挽救方案。在这项研究中，我们旨在分享我们在中心使用 GDP/R-GDP（利妥昔单抗-吉西他滨、地塞米松和顺铂）进行干细胞动员的患者经验。
回顾性分析 2014 年 7 月至 2020 年 1 月期间在我院接受 GDP/R-GDP 作为挽救性化疗的 69 例复发和难治性霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）患者的数据。在评估反应后，52 例患者疾病有缓解并接受 GDP/R-GDP 联合 G-CSF（粒细胞集落刺激因子）动员。根据 HL 和 NHL 诊断、早期和晚期、未接受 RT 和接受 RT、年龄<60 岁和>60 岁，比较采集的 CD34+干细胞和相关参数。
平均第 15 天（范围 11-20 天），52 例化疗敏感患者中 51 例（98%）采集了中位数为 8.7×106 /kg（4.1-41.5）的 CD34+干细胞，1 例（2%）患者动员失败。我们观察到可接受的血液学和非血液学毒性。98%（n=51）的患者达到了 2×106 /kg CD34+干细胞的目标量，他们均接受了自体干细胞移植。此外，低毒性谱为门诊使用提供了选择，密切随访和充分的支持性护理。
我们认为 GDP/R-GDP 联合 G-CSF 可作为一种有效的化疗方案，用于动员复发和难治性淋巴瘤患者外周血中的 CD34+干细胞，因其毒性低、肿瘤有效缩小和成功动员干细胞。此外，还可以假设 GDP 动员方案可能更有效，特别是在早期疾病和 HL 患者中。
