Remobilization of hematopoietic stem cells with high-dose methotrexate and cytarabine in patients with non-Hodgkin's lymphoma and multiple myeloma after failure to mobilize with chemotherapy and cytokines

摘要

High-dose chemotherapy followed by auto-logous stem cell transplantation (ASCT) is a widely used therapeutic modality for relapsed or primary refractory non-Hodgkin's lymphoma (NHL) and multiple myeloma (MM).1'2 Autologous stem cell collection (ASCC) is a prerequisite for ASCT. Multiple randomized studies have demonstrated the advantages of mobilized peripheral blood stem cells (PBSCs) over the marrow for ASCT.Cytokines, especially granulocyte-colony-stimulating factor (G-CSF) alone or in combination with chemotherapy have been commonly used for mobilization of stem cells to peripheral circulation. However, with these methods, between 5 and 30% of patients fail to mobilize and collect blood stem cells.4 Prior cytotoxic chemotherapy and advanced age are described as important factors that are associated with increased risk of mobilization failure.