Prediction of mobilisation failure in patients with non-Hodgkin's lymphoma

Bone Marrow Transplant. 2004 May;33(9):907-12. doi: 10.1038/sj.bmt.1704466.

Abstract

Factors affecting progenitor cell mobilisation in patients with non-Hodgkin's lymphoma (NHL) are incompletely understood. We have analysed factors predicting mobilisation failure in 97 consecutive patients with NHL (59 males, 38 females; median age 49 years) who received mobilisation with intermediate-dose CY (4 g/m(2)) followed by G-CSF. The histology included large cell B (N=50), mantle cell (N=16), follicular (N=16) and other NHL (N=15). The disease status was 1CR/PR/primary refractory in 66 patients and >1 CR/PR in 31 patients. The minimum criterion for successful mobilisation was the collection of >or=1.5 x 10(6)/kg CD34(+) cells. In all, 18 patients (19%) failed to reach this threshold. In univariate analysis, premobilisation factors associated with mobilisation failure included BM involvement at the time of diagnosis (P=0.001) or prior to mobilisation (P=0.001) and low platelet count just prior to mobilisation (P=0.001). In multivariate analysis, only BM involvement at diagnosis (P=0.004) and platelet count just prior to mobilisation (P=0.01) were associated with mobilisation failure. A mathematical model based on these two factors and presented in the form of a receiver operating characteristics curve showed a sensitivity of 0.71 and a specificity of 0.77 in the prediction of mobilisation failure. Patients at a high risk of mobilisation failure may benefit from novel approaches.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD34 / chemistry
  • Bone Marrow / pathology
  • Cohort Studies
  • Female
  • Granulocyte Colony-Stimulating Factor / pharmacology
  • Hematopoietic Stem Cell Mobilization*
  • Humans
  • Lymphoma, Non-Hodgkin / blood*
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Middle Aged
  • Models, Theoretical
  • Multivariate Analysis
  • ROC Curve
  • Risk
  • Sensitivity and Specificity
  • Stem Cells / metabolism
  • Treatment Outcome

Substances

  • Antigens, CD34
  • Granulocyte Colony-Stimulating Factor