Effective progenitor cell mobilization in lymphoproliferative disorders using ifosfamide, epirubicin and etoposide (IEV)

Eur J Haematol Suppl. 2001 Jul:64:33-6.

Abstract

The combination of ifosfamide, epirubicin and etoposide (IEV) is an effective salvage regimen for lymphoproliferative disease. We report our experience with this combination in mobilization of peripheral blood stem cells (PBSC) in patients with relapsed or refractory/high-risk lymphoma. The median time to leukapheresis was 14 days, with 85% of patients commencing PBSC collection in the range of 13-15 days. Mobilization was successful in 26 of 28 patients (93%), who achieved the minimum transplant dose of 2 x 10(6)/kg CD34+ cells in a median of 2 leukaphereses. Overall, the median CD34+ cell yield was 6.94 x 10(6)/kg (range 0.73-27.4). In 15 of 27 patients (54%), the yield was sufficient (> 6 x 10(6)/kg) to permit CD34+ cell selection and/or a second autograft. IEV was given as an inpatient in all cases. Patients were scheduled for discharge after chemotherapy. This was achieved in 71%, with readmission 1 week later for harvest. Therapy was complicated by neutropenic fever in 13 patients and mild nausea. In autografts carried out using IEV-mobilized PBSC (n = 20), the median time to neutrophils > 0.5 x 10(9)/L was 10 days (range 7-13 days), and to platelets > 20 x 10(9)/L was 13 days (range 11-18 days). There was no mobilization- or transplant-related mortality. We conclude that IEV is a safe, predictable and highly effective mobilization regimen in patients with lymphoma.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD34 / analysis
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / toxicity
  • Epirubicin / administration & dosage
  • Epirubicin / toxicity
  • Etoposide / administration & dosage
  • Etoposide / toxicity
  • Female
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cell Mobilization / standards
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Ifosfamide / administration & dosage
  • Ifosfamide / toxicity
  • Leukapheresis / standards
  • Lymphoma / complications
  • Lymphoma / drug therapy
  • Lymphoma / therapy
  • Lymphoproliferative Disorders / complications
  • Lymphoproliferative Disorders / drug therapy*
  • Lymphoproliferative Disorders / therapy
  • Male
  • Middle Aged
  • Salvage Therapy / methods
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Antigens, CD34
  • Epirubicin
  • Etoposide
  • Ifosfamide

Supplementary concepts

  • IEV protocol