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High-Dose Etoposide Plus Granulocyte Colony-Stimulating Factor as an Effective Chemomobilization Regimen for Autologous Stem Cell Transplantation in Patients with Non-Hodgkin Lymphoma Previously Treated with CHOP-based Chemotherapy: A Study from the Consortium for Improving Survival of Lymphoma

 Shin Young Hyun  ;  June-Won Cheong  ;  Soo-Jeong Kim  ;  Yoo Hong Min  ;  Deok-Hwan Yang  ;  Jae-Sook Ahn  ;  Won-Sik Lee  ;  Hun-Mo Ryoo  ;  Young Rok Do  ;  Ho Sup Lee  ;  Jae Hoon Lee  ;  Sung Yong Oh  ;  Cheolwon Suh  ;  Ho-Young Yhim  ;  Jin Seok Kim 
 Biology of Blood and Marrow Transplantation, Vol.20(1) : 73-79, 2014 
Journal Title
 Biology of Blood and Marrow Transplantation 
Issue Date
Adult ; Aged ; Antigens, CD34/metabolism ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Biomarkers/metabolism ; Cisplatin/pharmacology ; Cyclophosphamide/pharmacology ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Etoposide/pharmacology* ; Female ; Granulocyte Colony-Stimulating Factor/pharmacology* ; Hematopoietic Stem Cell Mobilization/methods* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells/drug effects* ; Humans ; Lymphoma, Non-Hodgkin/immunology ; Lymphoma, Non-Hodgkin/mortality ; Lymphoma, Non-Hodgkin/pathology ; Lymphoma, Non-Hodgkin/therapy* ; Male ; Middle Aged ; Multivariate Analysis ; Prednisone/therapeutic use ; Retrospective Studies ; Survival Analysis ; Transplantation, Autologous ; Vincristine/therapeutic use
Cyclophosphamide ; Etoposide ; Non-Hodgkin lymphoma ; Platinum ; Stem cell mobilization
We conducted a multicenter retrospective study to compare the efficacy and toxicity of various chemomobilization regimens: high-dose (HD) cyclophosphamide, HD etoposide (VP-16), and platinum-based chemotherapies. We reviewed the experiences of 10 institutions with 103 non-Hodgkin lymphoma patients who had previously only been treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-based chemotherapy. The mobilization yields for each regimen were analyzed. HD VP-16 mobilized a significantly higher median number of CD34+ cells (16.22 × 106 cells/kg) than HD cyclophosphamide (4.44 × 106 cells/kg) or platinum-based chemotherapies (6.08 × 106 cells/kg, P < .001). The rate of successful mobilization (CD34+ cell count ≥5.0 × 106 cells/kg) was also significantly higher for HD VP-16 (86%) than for HD cyclophosphamide (45%) or platinum-based chemotherapies (61%, P = .004). The successful mobilization rate on day 1 of 72% for HD VP-16 was significantly higher than the rates for HD cyclophosphamide (13%) and platinum-based chemotherapies (26%, P < .001). In multivariate analysis, HD VP-16 was a significant predictor of successful mobilization (P = .014; odds ratio, 5.25; 95% confidence interval, 1.40 to 19.63). Neutropenic fever occurred in 67% of patients treated with HD VP-16. The incidence was similar for HD cyclophosphamide (58%, P = .454) but was significantly lower for platinum-based chemotherapies (12%, P < .001). However, fatal (grade ≥ 4) infection and treatment-related mortality were not observed in this study. In conclusion, the mobilization yield was significantly influenced by the chemomobilization regimen, and HD VP-16 was a highly effective mobilization regimen in patients with non-Hodgkin lymphoma.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
Hyun, Shin Yong(현신영)
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