Identification of factors associated with poor peripheral blood progenitorcell mobilization in Hodgkin's disease

Background and Objectives. Although the use of drugs which damage stem cell s is common in patients with Hodgkin's disease (HD), factors affecting peri pheral blood progenitor cell (PBPC) mobilization have not been clearly esta blished in this group of patients. The aim of this study was to identify fa ctors associated with poor PBPC mobilization in patients with HD. Design and Methods. In order to address this issue we evaluated, in 54 pati ents with HD mobilized with granulocyte colony-stimulating factor (G-CSF) a lone, the following factors: sex, age, histologic subtype, B-symptoms at di agnosis, status of remission, previous chemotherapy and radiotherapy, inter val from diagnosis and last chemotherapy cycle to harvest, and dose of G-CS F. Univariate analysis was performed using Student's t-test, Pearson's corr elation and Spearman's correlation, A stepwise regression model was used to determine which of the variables was the most predictive of PBPC mobilizat ion. Results. In univariate analysis poorer PBPC mobilization was observed in pa tients who had previously received at least two courses of mini-BEAM (p=0.0 06), a high number of different chemotherapy regimens (p=0.002), a chemothe rapy score > 30 (p=0.02) and more than 9 months of alkylating agents (p=0.0 7). We did not find radiotherapy to be a significant factor affecting proge nitor cell yield (p=0.59). In the stepwise regression model, only the previ ous administration of two or more mini-BEAM cycles predicted a poor PBPC yi eld (p=0.006). Interpretation and Conclusions. Previous chemotherapy, particularly exposur e to a mini-BEAM regimen, seems to be the principal factor affecting collec tion of PBPC in patients with HD mobilized with G-CSF alone. Since mini-BEA M is an effective salvage regimen in relapsed or refractory HD, collection of PBPC should be planned when there has been no or only minimal exposure t o a mini-BEAM regimen. (C) 2001, Ferrata Storti Foundation.