We analysed the factors influencing the efficacy of peripheral blood stem cell (PBSC) collection in patients with
lymphoma. Sixty-six patients underwent initial PBSC collection following mobilization with
chemotherapy plus recombinant
granulocyte colony-stimulating factor (300 microg/d). Patients were mobilized with one of two
chemotherapy regimens, either cyclophophamide (3 g/m2 or 4 g/m2) (n = 50) or ifosphamide,
etoposide and
epirubicin (IVE; n = 16). The target of collecting > 2.0 x 10(6) CD34+ cells/kg was achieved in 43/66 (65%) patients with a median of two
apheresis procedures. The IVE plus
G-CSF mobilization regimen gave a significantly higher median yield of CD34+ cells (8.62 x 10(6)/kg) compared with
cyclophosphamide plus
G-CSF (3.59 x 10(6)/kg) (P = 0.045). The median yield of CD34+ cells per leukapheresis was almost twice as high in patients receiving IVE (1.94 x 10(6)/kg) compared to
cyclophosphamide (1.03 x 10(6)/kg) (P = 0.035). In a univariate analysis of the factors affecting mobilization, the subtype of
lymphoma (high-grade NHL) and the mobilization regimen were the only factors associated with high CD34+ cell yield. However, in a multivariate analysis of factors affecting mobilization including age,
lymphoma subtype, previous
chemotherapy and
radiotherapy, only the use of the
IVE protocol was predictive of a high yield of CD34+ cells. In 13 patients undergoing a second mobilization procedure the use of IVE was associated with a significantly higher yield of CD34+ cells compared to
cyclophosphamide; three patients who failed
cyclophosphamide plus
G-CSF mobilization were able to proceed to
transplantation following successful mobilization with IVE +
G-CSF. These results demonstrate that IVE is a highly effective mobilization regimen which is superior to cyclophophamide and has the benefit of being effective
salvage therapy for
lymphoma patients.