A model of in vivo purging with Rituximab and high-dose AraC in follicular and mantle cell lymphoma

Bone Marrow Transplant. 2004 Jul;34(2):175-9. doi: 10.1038/sj.bmt.1704551.

Abstract

We studied a model of in vivo purging with Rituximab and high-dose (HD) cytarabine in 14 patients with relapsed/refractory follicular lymphoma and two with refractory mantle cell lymphoma enrolled in a program of HD chemotherapy and autotransplant. After two courses of debulking immunochemotherapy with Rituximab, Vincristine and Cyclophosphamide, we used a combination of Rituximab, HD cytarabine and granulocyte colony-stimulating factor for peripheral blood stem cells (PBSC) mobilization. The median number of CD34+ cells collected was 14.69 x 10(6)/kg (range 5.74-73.2). Monitoring of peripheral CD19+ and CD20+ B cells prior to and throughout the purging period showed that a treatment with Rituximab, Vincristine and Cyclophosphamide results in a profound depletion of B cells in peripheral blood. B-cell depletion persists during mobilization with Rituximab and HD cytarabine allowing a collection of PBSC free of B cells (median CD19+ and CD20+ cells counts 0%). Of nine patients PCR positive for bcl-2 or bcl-1 in blood and marrow at the start of immunochemotherapy, all showed PCR-negative PBSC. In conclusion, in patients with indolent lymphoma, the concurrent administration of Rituximab and HD cytarabine is a safe and efficient method to obtain in vivo purged PBSC. Immunochemotherapy prior to mobilization produces B-cell depletion and seems to be a useful preparative step.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antibodies, Monoclonal / pharmacokinetics
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD34 / analysis
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / immunology
  • Bone Marrow Purging / methods*
  • Cytarabine / therapeutic use*
  • Female
  • Hematopoietic Stem Cell Mobilization / methods*
  • Humans
  • Immunophenotyping
  • Lymphoma, Follicular / drug therapy*
  • Lymphoma, Follicular / therapy
  • Lymphoma, Mantle-Cell / drug therapy*
  • Lymphoma, Mantle-Cell / therapy
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation / methods
  • Rituximab
  • Salvage Therapy / methods
  • Transplantation, Autologous

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD34
  • Cytarabine
  • Rituximab