Scoring system for the prediction of successful peripheral blood stem cell(PBSC) collection in non-Hodgkin's lymphoma (NHL): application in clinicalpractice

Fifty-six patients with chemosensitive NHL were studied to assess factors a ffecting mobilization and peripheral blood stem cell (PBSC) collection: all were mobilized with high-dose cyclophosphamide and etoposide and G-CSF 5 m u g/kg/day. None of them had bone marrow involvement at the time of mobiliz ation or a history of extended field irradiation. Previous chemotherapy reg imens were divided into two groups: moderately myelotoxic chemotherapy (MMC ) and highly myelotoxic chemotherapy (HMC), The adequacy of the PBSC harves t was not associated with age, gender, a past history of bone marrow involv ement or disease status. In contrast, the number of MMC cycles (n((MMC))) a nd the number of HMC cycles (n((HMC))) were both significant (P = 0.009 and P = 0.0004, respectively) and were used to compute a score predictive of a successful PBSC harvest: SCORE = n((MMC)) + 4 n((HMC)). The estimated succ essful PBSC collection rate was greater than 80% in patients with a score r anging from 0 to 15 and dropped rapidly to below 20% in patients with a sco re exceeding 25, This scoring system may help to determine the timing of PB SC mobilization in patients with a score below 15 and suggests that new PBS C mobilization procedures should be investigated in other patients.