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STEM CELL MOBILIZATION WITH ETOPOSIDE AND G-CSF IN PATIENTS WITH RELAPSED/REFRACTORY CLASSIC HODGKIN LYMPHOMAстатья
- Авторы: Petrova Galina, Monin I., Nikiforova N., Zavodnova I., Orlova E., Maltseva L., Efirkina A., Zaguzina N., Grishina V., Kondakov I., Mkheidze D., Palladina A., Shpirko V., Baranova O., Kliuchagina I., Kichigina M., Ibragimov A., Antipova A.
- Сборник: Bone Marrow Transplantation (Bone Marrow Transplant). The 49th Annual Meeting of the European Society for Blood and Marrow Transplantation: Physicians – Poster Session (P001-P708)
- Том: 58
- Год издания: 2023
- Место издания: Nature
- Первая страница: 609
- Последняя страница: 609
- Номер статьи: P679
- Аннотация: Background: Hematopoietic stem cell collection with etoposide is reported to be highly effective in patients with multiple myeloma.Since the optimal mobilization strategy prior to autologous stem cell transplantation (ASCT) for patients with relapsed/refractory classic Hodgkin lymphoma (r/r cHL) has not been determined yet, here we present a single center experience of chemo-mobilization with intermediate-dose etoposide and granulocyte colony-stimulating factor (G-CSF) in patients with r/r cHL in the era of new drugs. Methods: Effectiveness of stem cell collection with etoposide and G-CSF in patients with r/r cHL between September 2019 and November 2022 was subjected to retrospective analysis. Mobilization schedule was as follows: etoposide at a dose of 375 mg/m2 in days 1 and 2 and filgrastim at a dose of 10 μg/kg/day once daily starting on day 4 and continued to the last day of stem cell apheresis. Results: During the indicated time frame 88 patients with r/r cHL (relapsed, n = 46; refractory, n = 42) underwent 90 aforementioned mobilization cycles. Patients’ median age was 33 (range 19-60). In 84 cases (93%) stem cell collection was performed for the first time, while in 6 cases (7%) etoposide was used as a second stem cell harvest regimen due to a previous failure following “steady-state” mobilization with G-CSF (n = 2), chemo-mobilization with etoposide (n = 2), gemcitabine (n = 1) or DHAP (n = 1). In 69% cases (n = 62/90) check-point inhibitors (nivolumab or pembrolizumab) were prescribed prior admission to stem cell collection unit (median courses 5, range 1-24). Just less than a half of patients (42/90; 47%) were treated with brentuximab vedotin (BV) before stem cells harvest (median courses 5, range 1-16). In 27% cases (n = 24/90) patients were consistently administered both nivolumab and BV. The median time from diagnosis to chemo-mobilization was 32 months (range 8,4–197). Intermediatedose etoposide and G-CSF administration resulted in successful collection ( > 2 × 10^6 CD34+ cells/kg) in 91 % of cases (n = 82/ 90) within a median 2 (1-4) apheresis days. Median total CD34+ cells/kg collected was 5,145 × 10^6 (0,116-18,7). Stem cells were harvested between days 11 and 15, with a median on the 12th day. Seventy-nine percent of patients (n = 71/90; 79%) were defined as good mobilizers as their yield was >2 × 10^6 CD34+ cells/kg in ≤2 days of apheresis. Subsequent ASCT was performed to 81% patients (n = 71/88). Hematopoietic recovery after ASCT was achieved at the expected time in all cases. Stem cell yield was affected significantly neither by patients’ age nor by diagnosis-tomobilization time interval. Prior exposure to targeted therapy with BV and/or immunotherapy with check-point inhibitors and its duration did not impair stem cell collection either (p > 0,05). Conclusions: Chemo-mobilization with intermediate-dose etoposide and G-CSF results in effective stem cell collection in majority of heavily pretreated r/r cHL patients in the era of novel agents. Clinical Trial Registry: not applicable. Disclosure: nothing to declare.