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
Seong Joon Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorDok Hyun Yoon
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorShin Kim
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKyungmin Lee
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJung Sun Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSeongsoo Jang
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChan-Jeoung Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorHuyn-Sook Chi
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChan-Sik Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJooryung Huh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Cheolwon Suh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Address reprint requests to: Cheolwon Suh, MD, PhD, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea; e-mail: [email protected].Search for more papers by this authorSeong Joon Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorDok Hyun Yoon
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorShin Kim
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKyungmin Lee
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJung Sun Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSeongsoo Jang
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChan-Jeoung Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorHuyn-Sook Chi
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChan-Sik Park
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorJooryung Huh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Cheolwon Suh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Address reprint requests to: Cheolwon Suh, MD, PhD, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea; e-mail: [email protected].Search for more papers by this authorAbstract
Background
High-dose chemotherapy supported by autologous stem cell transplantation is an effective treatment for patients with relapsed or refractory non-Hodgkin's lymphomas (NHLs) and fit patients with multiple myeloma (MM). However, failure rates of hematopoietic stem cell mobilization are estimated to be between 5 and 30%, respectively. Thus, we investigated the efficacy of the combination chemotherapy of high-dose methotrexate (MTX) and cytarabine with granulocyte-colony-stimulating factor (G-CSF) as a remobilization method in those who failed a prior mobilization and collection with chemotherapy and G-CSF.
Study Design and Methods
Mobilization failure was defined as a collection of fewer than 5 × 106 CD34+ cells after three to five apheresis procedures. MTX (3500 mg/m2 in a 120-min infusion) on Day 1 and cytarabine (3000 mg/m2 infusion for 120 min) on Day 4 and Day 5 were followed by G-CSF (10 μg/kg daily).
Results
A total of eight patients (six NHL and two MM; median age, 55 years) who had failed in prior mobilization with conventional chemotherapy and G-CSF underwent the second mobilization as described in the method. Successful collection of CD34+ cells (> 5 × 106/kg) was achieved in six patients (75%) with three to five apheresis procedures. The total yield of CD34+ cells/kg body weight was 6.28 × 106/kg (median; range, 1.53 × 106-10.09 × 106/kg).
Conclusions
This preliminary result warrants further investigation of high-dose MTX and cytarabine plus G-CSF as a means to remobilize stem cells in those with prior failure to mobilize stem cells with chemotherapy and G-CSF.
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