Mobilization of peripheral blood stem cells with mitoxantrone and high-dose cytarabine chemotherapy and rhG-CSF in patients with hematopoietic malignancies

Objective To evaluate the efficacy of mitoxantrone combined high dose of cytarabine and recombinant human granulocyte colony-stimulating factor(MAG) regimen for mobilizing autologous peripheral blood stem cells (APBSC) in patients with hematopoietic malignancies. Methods From December 1995 to April 2003, 14 lymphoma and 29 acute leukemia patients were treated with high-dose cytarabine (2 g/m 2 every 12 h, days 1 and 2) and mitoxantrone (10 mg/m 2, days 2 and 3), followed by 300 microgram recombinant human granulocyte colony-stimulating factor per day(rhG-CSF 300 μg/d) i.e, the MAG regimen as mobilization regimen of peripheral blood stem cells. rhG-CSF was given subcutaneouly when the white blood cell (WBC) count below 1.0×10 9/L following the MA chemotherapy, APBSC were harvested when WBC count increased using Baxter CS3000plus or Cobe Spectra. Results Mobilization was successful in 13 of 14 lymphoma patients with MNC (3.91±2.70)×10 8/kg,CD34 + cells (17.79±12.90)×10 6/kg. Meanwhile, mobilization was successful in 24 of 29 acute leukemia patients with average of 2.13 times for apheresis. The median MNC and CD34 + cells yielded were 3.62×10 8/kg and 7.37×10 6/kg respectively, rhG-CSF was used for a median time of 7 days. Excepting for gradeⅠ～Ⅱgastrointestinal toxicity in 8 and infection in 14 cases, no major side effects were observed. There was no mobilization-related mortality. Minimal residual diseases became undetectable after mobilization in some patients. Conclusion MAG is a safe and highly effective mobilization regimen in patients with lymphoma and acute leukemia.