ESHAP plus fixed dose G-CSF as autologous peripheral blood stem cell mobilization regimen in patients with relapsed or refractory diffuse large cell and Hodgkin's lymphoma: a single institution result of 127 patients

From 1996 to November 2004, 131 consecutive patients with relapsed or refractory diffuse large cell lymphoma (DLCL) and Hodgkin's lymphoma (HD) received ESHAP as mobilization chemotherapy before autologous peripheral blood stemcell transplant ( ASCT). Patients received fixed dose G-CSF 300 mu g SC bid starting 24 - 36 h after finishing mobilizing ESHAP. In all, four patients failed mobilization and are excluded. Characteristics of 127 patients: 68 males: 59 females. DLCL 49: HD 78. Initial stage I: II: III: IV: unknown was 15: 34: 33: 42: 3. Median age at ASCT 26 years. Median prior chemotherapy cycles were six {<6 ( 17 patients), 6 - 8 ( 90 patients), 48 ( 20 patients)}. Median ESHAP cycle used as mobilizer was third. Patients required 1, 2, 3, 4 apheresis were 93: 25: 8: 1. Median total CD34+ cells/kg collected were 6.9 x 10(6) ( DLCL 5.17 x 10(6) and HD 7.6 x 10(6)), patients weighing <= 70 kg ( 93 patients) 6.54 x 10(6) and 470 kg (34 patients) 7.44 x 10(6) ( P = 0.59), one apheresis (93 patients) 8.6 x 10(6)/ kg and >1 apheresis ( 34 patients) 4.5 x 10(6) ( P = 0.001). We conclude that ESHAP and G-CSF 300 mu g SC bid is an effective mobilizing regimen even in patients 470 kg and most patients require only 1 - 2 apheresis.