Mobilizing potential of ifosfamide/vinorelbine-based chemotherapy in pretreated malignant lymphoma

Abstract

The mobilizing potential and therapeutic activity of ifosfamide/vinorelbine-containing regimens with G-CSF support were explored in patients with pretreated malignant lymphomas. Ten patients with non-Hodgkin's lymphoma (NHL) received ifosfamide and vinorelbine, and 17 with Hodgkin's disease (HD) received ifosfamide, vinorelbine and gemcitabine (IGEV regimen), as induction chemotherapy before high-dose chemotherapy (HDT) with peripheral blood stem cell (PBSC) support. Most of the patients had been heavily pretreated with various chemotherapy regimens ± radiotherapy. The target yield was 3 × 10⁶ CD34⁺ cells/kg of body weight in order to support the subsequent myeloablative chemotherapy. The optimal PBSC harvest occurred on days 11 and 12, with no difference in CD34⁺ cell mobilization kinetics between the ifos- famide/vinorelbine and IGEV regimens. The median number of CD34⁺ cells/kg body weight collected was 10.9 × 10⁶ (range 1.76–61.1 × 10⁶). The median total CD34⁺ cell/μl, CFU-GM and white blood cells (WBC) for all individual collections was 81.5/μl, 10 × 10⁴/kg, and 17 900/μl, respectively. The target yield of CD34⁺ cells was reached in 24 of 27 patients. Hematological side-effects were acceptable and no treatment-related hospitalizations or toxic deaths occurred. Fifteen patients have so far received high-dose therapy and PBSC reinfusion with rapid engraftment. These results confirm that ifosfamide and vinorelbine-based chemotherapy regimen with G-CSF support can be successfully and safely used to mobilize PBSCs. Bone Marrow Transplantation (2001) 28, 923–927.