Mobilized versus non-mobilized peripheral stem cell transplantation after high dose therapy for low grade nonhodgkin lymphoma: Effect on failure-free survival

Problem Investigators have recently reported that intentional mobilization of progenitors into the circulation of cancer patients using myelosuppressive chemotherapy and/or hematopoietic growth factor is sometimes associated with an increased number of circulating malignant cells. Therefore, collections of mobilized autologous peripheral stem cells for transplantation could potentially contain more occult tumor cells than collections of non-mobilized cells. If these mobilized tumor cells were capable of restoring disease when reinfused to patients undergoing high dose therapy and peripheral stem cell transplantation (PSCT), then patients receiving mobilized PSCT would be at risk for a poorer failure-free survival than patients autografted with non-mobilized cells. Methods To investigate this premise, the outcomes of all patients with low grade non-Hodgkin lymphoma (NHL) treated at a single institution before April 15, 1994 with high dose therapy and PSCT were reviewed. Results Thirty-seven patients received nonmobilized peripheral stem cells at the time of autografting and 64 patients were transplanted with autologous cells that had been mobilized with hematopoietic growth factor. Following PSCT, no differences were found in the failure-free survival of patients who received mobilized versus non-mobilized cells for transplant. Conclusion Growth factor mobilization did not influence the relapse rate for these patients with low grade NHL following peripheral stem cell autografting.