Cytarabine assures a high concentration of circulating CD34+ cells during haematopoietic stem cells mobilization in lymphoma patients
MetadataShow full item record
Background Mobilization of haematopoietic stem cells for autologous transplantation in lymphoma patients currently lacks optimal and universally accepted protocol guidelines. Available mobilization procedures use either cytokines alone, predominantly granulocyte colony-stimulating factor, or cytokines in combination with chemotherapy. Chemomobilization may increase the CD34+ cell yield, and some studies indicate that a higher number of CD34+ cells reinfused is associated with better outcome after autologous haematopoietic stem cells transplantation. We aimed to compare the peak of CD34+ cells in peripheral blood between two alternative mobilization therapies in a retrospective cohort of patients affected by lymphoma. Methods Between 2001–2012, 125 retrospectively observed lymphoma patients were treated with either cytarabine ( n=36 ) or cyclophosphamide ( n=89 ), both combined with granulocyte colony-stimulating factor. The difference in the peak of circulating CD34+ cells was the study primary endpoint. Results The peak of circulating CD34+ cells were significantly higher in the cytarabine group compared with the cyclophosphamide group (median 129/μL vs 77/μL; p<0.05 ), even when accounting for the timing at collection (169% higher in the cytarabine group, p<0.01 ). Haematopoietic stem cells median time collection started 3 days later in the cytarabine group (16 vs 13 days; p<0.01 ). A leukaphaeresis single session was adequate to collect an optimal number of CD34+ cells (greater than 5×106/kg ) in 69% patients in the cytarabine group compared with 57% in the cyclophosphamide group ( p=0.21 ). Conclusions Cytarabine gives a higher peak of circulating CD34+ cells in comparison with cyclophosphamide in a retrospective observational cohort of lymphoma patients submitted to chemomobilization.