2. Academic Validation
  3. Impact of frontline fludarabine and cyclophosphamide combined treatment on peripheral blood stem cell mobilization in B-cell chronic lymphocytic leukemia

Impact of frontline fludarabine and cyclophosphamide combined treatment on peripheral blood stem cell mobilization in B-cell chronic lymphocytic leukemia

  • Blood. 2004 Jan 1;103(1):363-5. doi: 10.1182/blood-2003-05-1449.
Olivier Tournilhac 1,  Bruno Cazin,  Stéphane Leprètre,  Marine Diviné,  Karim Maloum,  Alain Delmer,  Bernard Grosbois,  Pierre Feugier,  Frederic Maloisel,  Florence Villard,  Bruno Villemagne,  Dominique Bastit,  Karim Belhadj,  Nabi Azar,  Mauricette Michallet,  Geraud Manhès,  Philippe Travade
Affiliations

Affiliation

  • 1 Service d'Hématologie Clinique, Hôtel Dieu, Centre Hospitalier Universitaire, Clermont-Ferrand, Paris, France.
PMID: 12969985 DOI: 10.1182/blood-2003-05-1449
Abstract

Ongoing studies in B-cell chronic lymphocytic leukemia are evaluating autologous peripheral blood stem cell (PBSC) transplantation in first remission following fludarabine therapy. However, fludarabine could impair PBSC harvest. In 38 patients after frontline oral fludarabine and cyclophosphamide (FDR-CY) therapy, we prospectively evaluated steady state filgrastim- or lenograstim-primed PBSC mobilization to collect 2.0 x 106/kg or more CD34 cells. The first mobilization, performed a median of 178 days (range, 69-377 days) from the last FDR-CY course, was unsuccessful in 32 patients. This result was significantly associated with a low platelet count before mobilization but not with age, interval from last FDR-CY course, initial stage, remission status, or other blood parameters. Finally, after 1, 2, and 3 mobilizations in 27, 10, and 1 patients, 2.0 x 106/kg or more CD34 cells were collected in only 12. Explorations of the mechanism of poor mobilization and adaptation of PBSC harvest policies after fludarabine treatment are therefore warranted.

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