Feasibility of ESHAP plus G-CSF as peripheral blood hematopoietic progenitor cell mobilisation regimen in resistant and relapsed lymphoma: a single-center study of 22 patients

The purpose was study the feasibility of ESHAP + G-CSF for peripheral blood hematopoietic progenitor cell (PBPC) mobilisation in resistant/relapsed Ho dgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). Twenty-two consecuti ve patients with HD (8) and N-HL (14) received ESHAP chemotherapy and G-CSF (5 mu g/Kg/d), When a minimum number of 10,000 peripheral blood CD34+ cell s/mL was observed patients underwent leukapheresis until a CD34+ cell dose greater than or equal to 2.5x10(6)/Kg was collected or the PBPC peak was lo st. Blood cells kinetics and toxicity were analysed. Data concerning the da y of first apheresis, number of procedures per patient, and cellular yield of the aphereses were recorded. Correlation between the CD34+ cell content in the apheresis product and the two diagnosis groups was attempted. Twelve patients (54%) developed short-lived severe neutropenia (<0.5x10(9)/L). Th rombocytopenia (<25x10(9)/L) had a median duration of 1 day. Fever appeared in 4 patients and CN Staph bacteriemia in 2 cases. Bleeding events did not supervene and no deaths occurred. Aphereses started at day +15 (median) an d the median number of apheresis/patient was 2. Seventeen patients underwen t 1 or 2 leukaphereses. Thirteen patients (59%) achieved the CD34+ cell tar get in the first apheresis, NHL patients obtained statistically significant better CD34+ cell collections than HD. Only 2 HD patients failed to mobili se, 1 previously treated with high-dose therapy and autologous bone marrow transplantation. ESHAP + G-CSF has been shown to be feasible for PBPC mobil isation in resistant/relapsed lymphoma. Toxicity was low and CD34+ cell yie ld high, especially in N-HL. This mobilisation regimen should be further ex plored in a larger patient population.