1. ¹Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, Italy
2. ²Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
3. ³Division of Internal Medicine, San Luigi Hospital, Gorgonzola, Italy

Correspondence: Dr M Magagnoli, Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Milano), Milano 20089, Italy. E-mail: massimo.magagnoli@humanitas

Received 24 April 2007; Revised 13 July 2007; Accepted 13 July 2007; Published online 1 October 2007.

Abstract

We explored the efficacy of the IGEV regimen (ifosfamide, gemcitabine, vinorelbine and prednisone) combined with a fixed dose of lenograstim (263 g/day) to mobilize peripheral blood stem cells (PBSCs) in 90 Hodgkin's lymphoma patients. The median total CD34+ cells/l peak, colony-forming units granulocyte–macrophage and white blood cells for all individual collection sets were 85/l, 12 10⁴/kg and 20 700/l, respectively. An adequate number of CD34+ cells (more than 3 10⁶ or 6 10⁶ CD34+ cells/kg depending on whether single or tandem high-dose chemotherapy was used) were collected in 89 out of 90 (98.7%) mobilized patients, whereas the only failure reached 2.3 10⁶ CD34+ cells/kg. The median CD34+ cell collections were 11 10⁶/kg (range 2.3–39 10⁶/kg) and 10 10⁶/kg (range 6–22.0 10⁶/kg) with a median of 1 and 2 leukaphereses for patients eligible for single high-dose treatment and for candidates for tandem transplant, respectively. Target yields were reached in 71.43 and 49.09% and additionally in 17.14 and 43.64% of cases after the first and second apheresis procedures, respectively. Hematological and non-hematological side effects were acceptable, and no toxic deaths occurred. Thirty-four patients received a single and 47 received tandem transplantation with rapid engraftment. These results confirm that the IGEV regimen with lenograstim support can be used successfully and safely to mobilize PBSCs.