Intensive dose ifosfamide and etoposide with G-CSF for stem cell mobilization in patients with non-Hodgkin's lymphoma

We studied 36 patients with non-Hodgkin's lymphoma to evaluate the stem cel l yield following recovery from intensive dose ifosfamide and etoposide giv en as mobilization chemotherapy. We also assessed the toxicity of the regim en and engraftment kinetics. All patients had intermediate grade lymphoma a nd had either failed to achieve a complete remission to induction chemother apy or had relapsed. Patients received ifosfamide 10 g/m(2) TV total dose g iven over 72 hours, etoposide 150 mg/m(2) IV every 12 hours for 6 doses and G-CSF 10 mu g/kg/d. Thirty-four patients went on to receive high-dose chem otherapy with BEAM or with CVP and BEAM. A median of 2 (1-10) apheresis was required to reach the target CD34+ count of >4 x 10(6)/kg. A median of 13. 1 CD34+ cells/kg (4.1-148) was obtained. Toxicity was limited to mucositis in 3 patients, transient confusion and transient rise in liver function tes ts in 3 and 2 patients respectively. The median time to engraftment was 10 days (8-17) for all the patients undergoing high-dose chemotherapy. The reg imen of intensive dose ifosfamide and etoposide along with G-CSF is well to lerated and in this group of patients has lead to successful stem cell harv ests and sustained engraftment.