Evaluation of rituximab on purgation and mobilization of peripheral blood stem cells in patients with B-cell non-Hodgkin lymphoma

Objective To investigate the effect of rituximab on purging peripheral blood stem cells and mobilization in patients with B-cell non-Hodgkin lymphoma(NHL). Methods Eight B-cell NHL (stage Ⅲ/Ⅳ)patients received the combination mobilization program composed of high-dose cyclophosphamide (HD-CTX), granulocyte colony-stimulating factor(G-CSF) and rituximab (375 mg·m-2·d-1, on d-1 and d7) after 4 to 6 courses of induction and/or consolidation chemotherapy (CHOP or CHOP-like) ± rituximab. Adverse reactions related to rituximab, the period of myelosuppression, complications, the PBSC harvest time and quantity, and the tumor marker genes in harvests were evaluated. Results Only one patient occurred mild erythra in the mobilizing courses. Leukaphereses were started on (11.6±1.0)d after the end of chemotherapy and adequate mononuclear cells (MNC) could be obtained in median of 2(1～3) times harvest procedures. The mean numbers of MNC and CD+34 cells harvested separately was (3.4±1.0)×108/kg, (3.6±1.7)×106/kg. Five patients accomplished auto-peripheral blood stem cells transplantation (APBSCT), IgH/TCR shifted to negative in three patients, and remained negative in one after APBSCT. Four patents were still in disease free survival; one relapsed at 3 months after APBSCT. Conclusion The addition of rituximab did not compromise the collection efficiency in non-Hodgkin lymphoma patients. Rituximab could potentially purge the graft of occult CD+20 tumor cells.