A randomized study comparing chemotherapy followed by G-CSF alone or in combination with GM-CSF for mobilization of peripheral blood stem cells in patients with non-Hodgkin's lymphomas.

摘要: Objective Granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating (GM-CSF) are the two most commonly used cytokines for mobilization of stem cells in patients undergoing high dose chemotherapy with cell support. Both increase peripheral blood white count but there other differences products mobilized by G-CSF versus those GM-CSF. Generally higher numbers dendritic GM-CSF than G-CSF. The primary objective this randomized study was to evaluate safety efficacy plus B-cell non-Hodgkin's lymphoma (NHL) who were chemo-mobilization. Secondary objectives determine expression various subsets groups incidence disease progression or relapse at 12 months. Methods We prospectively evaluated 84 relapsed NHL candidates therapy (HDT). All underwent chemo-mobilization using ifosfamide, etoposide, rituximab. an adaptive manner receive either (G+GM) starting 24 hours after completion continuing until apheresis. yield/kg, number apheresis procedures needed groups, toxicity recorded. also enumerated subsets, myeloid DCs (mDC) plasmacytoid (pDC), (PB) samples collected pre-chemotherapy. data expressed as a percentage mononuclear cells. Results A total treated. Forty-three received 41 G+GM. regimens well tolerated. median CD34+ similar groups. 54 (G-CSF N = 25 G+GM 29) paired from baseline post-apheresis available analysis subsets. There no significant difference percentages mDC between mobilization. However, pDC alone when compared arm (P 0.002). Furthermore, ratio significantly lower 0.029). Conclusion Addition regimen resulted alone. This shifts mDC/pDC grafts favor combination arm. these did not seem impact clinical outcomes (ClinicalTrials.gov Identifier: NCT00499343).