Article

Impact of rituximab on stem cell mobilization following ACVBP regimen in poor-risk patients with diffuse large B-cell lymphoma: results from a large cohort of patients.

From the Département de Biothérapie, Hôpital Necker, AP-HP, Paris, France; the Etablissement Français du Sang, Région Normandie, France; the Etablissement Français du Sang, Région Rhône-Alpes, France; the Etablissement Français du Sang, Région Pyrénées-Méditerranée, France; the Etablissement Français du Sang, Lorraine-Champagne, France; the Service d'Hématologie, CHU, Strasbourg, France; the Service d'Hématologie, Centre Henri Becquerel, Rouen, France; the Service d'Hématologie, CHU Lyon Sud, Lyon, France; the Département de Médecine and the Centre de Thérapie Cellulaire, Institut de Cancérologie Gustave Roussy, Villejuif, France; the Service d'Hématologie Oncologie and Unité de Thérapie Cellulaire, Hôpital Saint-Louis, AP-HP, Paris, France; the Service d'Hématologie, Hôpital Purpan, CHU Toulouse, France; the Service d'Hématologie, Hôpital Brabois, CHU Nancy, France; the Service d'Hématologie, Polyclinique Bordeaux Nord, France; the Service d'Onco-Hématologie, Hôpital l'Archet, CHU Nice, France; and the Unité Hémopathies Lymphoïdes, Hôpital Henri-Mondor, Université Paris Est Créteil, Créteil, France.
Transfusion (impact factor: 3.22). 05/2012; DOI:10.1111/j.1537-2995.2012.03683.x
Source: PubMed

ABSTRACT BACKGROUND: The ACVBP regimen is an efficient induction regimen for poor-risk patients with diffuse large B-cell lymphoma (DLBCL) before consolidative autologous stem cell transplantation. Adjunction of the monoclonal anti-CD20 antibody rituximab (R-ACVBP) was recently found to be superior to ACVBP alone. This study assessed the impact of rituximab on stem cell mobilization in two similar consecutive groups of patients treated with ACVBP in two prospective, controlled trials. STUDY DESIGN AND METHODS: The first trial (LNH-98B-3) involved 137 patients treated with ACVBP alone. In the second trial (LNH-03-3B), 91 patients received an R-ACVBP regimen. Stem cell mobilization was performed after a course of (R)-ACVBP. RESULTS: The median peak numbers of blood CD34+ cell counts recorded before the first apheresis procedure in the ACVBP and R-ACVBP groups were 69 × 10(6) and 63 × 10(6) /L, respectively (p = 0.55). The median numbers of CD34+ cells collected were 7.1 × 10(6) and 6.0 × 10(6) CD34+ cells/kg for the ACVBP and R-ACVBP groups, respectively (p = 0.13). The median number of apheresis procedures required for gathering the minimum amount of CD34+ cells (2 × 10(6) /kg) was the same in the two groups. CONCLUSION: When compared with ACVBP alone, adjunction of rituximab does not impair stem cell mobilization.

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Keywords

adjunction
 
apheresis procedures
 
blood CD34+ cell counts
 
cell mobilization
 
consolidative autologous
 
diffuse large B-cell lymphoma
 
efficient induction regimen
 
first apheresis procedure
 
first trial
 
median peak numbers
 
poor-risk patients
 
R)-ACVBP
 
R-ACVBP
 
R-ACVBP groups
 
R-ACVBP regimen
 
second trial
 
similar consecutive groups
 
Stem cell mobilization
 
trials
 
two groups