Successful peripheral blood stem cell mobilization with etoposide (vp-16) in patients with relapsed or resistant lymphoma who failed cyclophosphamide mobilization

ABSTRACT High-dose chemotherapy (HDCT) followed by autologous blood stem cell transplantation is considered the treatment of choice for patients with relapsed or resistant aggressive

non-Hodgkin’s lymphoma (NHL) or Hodgkin’s disease (HD). However, several authors report failure of standard mobilization regimens in 29% to 56% of these patients making the completion of

HDCT impossible and as a result, negatively influencing long-term outcome. Thus, effective new regimens for patients failing initial mobilization are needed. Here we report the results of

using etoposide as a mobilizing agent in 16 patients with primary resistant or relapsed malignant lymphoma who had failed prior mobilization of peripheral blood stem cells (PBSC) with

cyclophosphamide (4 g/m2) followed by G-CSF. The use of etoposide 500 mg/m2 (days 1–4) + G-CSF resulted in the successful collection of adequate numbers of PBSC with a median harvest of 3.6 

× 106/kg (range 2.2–12.6) CD34+ cells in all 16 patients. In 7/16 (44%) patients, the target yield of at least 2.0 × 106CD34+ cells was harvested by a single apheresis and the maximum number

of separations for all patients was two. No excessive toxicities appeared, allowing all patients to proceed to myeloablative chemotherapy. In addition, median peak values of circulating

CD34+cells were significantly higher after etoposide as compared to cyclophosphamide (49.2/μl _vs_4.7/μl; _P_ = 0.0004). These results indicate that etoposide + G-CSF is a highly effective

mobilization regimen in patients who have failed cyclophosphamide mobilization. Access through your institution Buy or subscribe This is a preview of subscription content, access via your

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2020 AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * First Department of Internal Medicine, University Hospital Köln, Köln, Germany M Reiser, A Josting, A Draube, C Scheid, J Chemnitz, H

Tesch, J Wolf, V Diehl, D Söhngen & A Engert * Department of Hematology, Oncology, and Tumorimmunology, University Center Charité, Berlin, Germany MY Mapara Authors * M Reiser View

author publications You can also search for this author inPubMed Google Scholar * A Josting View author publications You can also search for this author inPubMed Google Scholar * A Draube

View author publications You can also search for this author inPubMed Google Scholar * MY Mapara View author publications You can also search for this author inPubMed Google Scholar * C

Scheid View author publications You can also search for this author inPubMed Google Scholar * J Chemnitz View author publications You can also search for this author inPubMed Google Scholar

* H Tesch View author publications You can also search for this author inPubMed Google Scholar * J Wolf View author publications You can also search for this author inPubMed Google Scholar *

V Diehl View author publications You can also search for this author inPubMed Google Scholar * D Söhngen View author publications You can also search for this author inPubMed Google Scholar

* A Engert View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Reiser,

M., Josting, A., Draube, A. _et al._ Successful peripheral blood stem cell mobilization with etoposide (VP-16) in patients with relapsed or resistant lymphoma who failed cyclophosphamide

mobilization. _Bone Marrow Transplant_ 23, 1223–1228 (1999). https://doi.org/10.1038/sj.bmt.1701791 Download citation * Received: 23 November 1998 * Accepted: 19 January 1999 * Published: 15

June 1999 * Issue Date: 01 June 1999 * DOI: https://doi.org/10.1038/sj.bmt.1701791 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get

shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * stem cell

mobilization * CD34+ cells * etoposide * cyclophosphamide * mobilization failure * stem cell transplantation