Contributed equally to this work.
TRANSPLANTATION AND CELLULAR ENIGINEERING
High-dose methotrexate in the mobilization of hematopoietic stem cells for patients with non-Hodgkin's lymphoma: a twelve-year study in a single center
Version of Record online: 16 DEC 2013
© 2013 AABB
Volume 54, Issue 5, pages 1251–1255, May 2014
How to Cite
Zhang, C., Chen, X.-H., Gao, L., Liu, Y., Gao, L., Kong, P.-Y., Zeng, D.-F., Peng, X.-G., Sun, A.-H. and Zhang, X. (2014), High-dose methotrexate in the mobilization of hematopoietic stem cells for patients with non-Hodgkin's lymphoma: a twelve-year study in a single center. Transfusion, 54: 1251–1255. doi: 10.1111/trf.12516
- Issue online: 12 MAY 2014
- Version of Record online: 16 DEC 2013
- Manuscript Accepted: 23 AUG 2013
- Manuscript Revised: 20 AUG 2013
- Manuscript Received: 15 JUL 2013
- National Natural Science Foundation. Grant Number: 81170529
- Natural Science Foundation Project of CQ “CSTC”. Grant Number: 2010BB5178
- Key Discipline of Medical Science of Chongqing
- Xinqiao Hospital of Third Military Medical University
High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) is a promising approach for non-Hodgkin's lymphoma (NHL). Higher cell doses have been associated with a faster blood count recovery and a reduction in transfusion requirements, infection rates, and hospitalization times. Mobilization failure constitutes one of the main reasons for avoiding auto-HSCT. The role of high-dose methotrexate (MTX) as mobilization regimen is still unclear.
Study Design and Methods
The effect of high-dose MTX as a mobilization regimen for 67 adult patients with NHL who received auto-HSCT was studied between January 2001 and October 2012. The stem cells were mobilized using combination chemotherapy including MTX plus granulocyte–colony-stimulating factor (G-CSF) in 33 patients (Group A), and the stem cells of the other 34 patients were mobilized using the same combination chemotherapy plus G-CSF without MTX (Group B).
All of the patients were successfully mobilized in Group A; however, two patients failed in Group B. The median numbers of CD34+ cells collected were 14.36 × 106 and 5.3 × 106 cells/kg for Groups A and B, respectively (p < 0.05). All of the patients experienced a stable neutrophil and platelet (PLT) engraftment. The times to white blood cell engraftment were 8.0 days in Group A and 11.0 days in Group B, and the times to PLT engraftment were 12.0 days in Group A and 13.0 days in Group B (p < 0.05 for both variables).
High-dose MTX is a powerful regimen component for stem cell mobilization in adult patients with NHL.