Randomized comparison of mobilization kinetics of circulating CD34+ cells between biweekly CHOP and dose-escalated CHOP with the prophylactic use of lenograstim (glycosylated rHuG-CSF) in aggressive non-Hodgkin's lymphoma. The lenograstim/Lymphoma Study Group.

Abstract

High-dose chemotherapy with autologous hematopoietic stem cell transplantation has been expected to result in a promising outcome in high risk aggressive non-Hodgkin's lymphoma (NHL). However, it remains unknown what type of initial chemotherapy is optimal, especially regarding progenitor cell mobilization. Sixty-three untreated patients with aggressive NHL in a high risk group were randomized to either a biweekly arm with 8 cycles of standard CHOP or 6 cycles of the dose-escalated CHOP arm with cyclophosphamide 1.5 g/m2 and doxorubicin 70 mg/m2. Lenograstim (glycosylated rHuG-CSF 2.0 microg/kg/day) was administered daily from day 3 to patients in both arms. The mobilization effect of the two regimens on circulating CD34+ cells was evaluated. Twenty-seven of 29 patients in the biweekly CHOP arm and 33 of 34 patients in the dose-escalated CHOP were assessable. Dose-escalated CHOP yielded a significantly higher number of circulating CD34+ cells in the first cycle compared with biweekly CHOP (p=0.05). The peak number of circulating CD34+ cells with biweekly CHOP did not significantly change from cycle to cycle; however, in dose-escalated CHOP, the peak number of circulating CD34+ cells mobilized after the fifth and sixth cycle was lower than after the first cycle (p=0.07 and 0.009, respectively). Routine conventional-dose chemotherapy and low-dose G-CSF can mobilize sufficient CD34+ cells in patients with aggressive NHL. The mobilization kinetics of circulating progenitor cells in patients with aggressive NHL is dependent on the dosage and schedule of CHOP.

• Authors: K Itoh, T Ohtsu, Y Sasaki, M Ogura, Y Morishima, M Kasai, T Chou, K Yoshida, T Ohno, F Mizorogi, N Uike, T Sai, M Taniwaki, S Ikeda, K Tobinai
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 38 Issue 5-6 Pg. 521-32 (Aug 2000) ISSN: 1042-8194 [Print] United States
• PMID: 10953973 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Adjuvants, Immunologic
• Recombinant Proteins
• Granulocyte Colony-Stimulating Factor
• Vincristine
• Lenograstim
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adjuvants, Immunologic (administration & dosage)
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Combined Modality Therapy
• Cyclophosphamide (administration & dosage)
• Doxorubicin (administration & dosage)
• Female
• Granulocyte Colony-Stimulating Factor (administration & dosage)
• Hematopoietic Stem Cell Mobilization
• Hematopoietic Stem Cell Transplantation
• Humans
• Lenograstim
• Lymphoma, Non-Hodgkin (pathology, physiopathology, therapy)
• Male
• Middle Aged
• Prednisone (administration & dosage)
• Recombinant Proteins (administration & dosage)
• Transplantation, Autologous
• Vincristine (administration & dosage)