Mini-ICE effectively mobilises peripheral blood stem cells after fludarabine-based regimens in acute myeloid...

Area of Science:

• Hematology
• Oncology
• Stem Cell Transplantation

Background:

• Fludarabine-based chemotherapy regimens significantly impair peripheral blood stem cell (PBSC) mobilization and collection in acute myeloid leukemia (AML) patients.
• This impairment poses a challenge for autologous PBSC transplantation, limiting therapeutic options for heavily pretreated individuals.

Purpose of the Study:

• To evaluate the efficacy of a low-dose 5-day Mini-ICE regimen in reversing the negative effects of fludarabine on PBSC mobilization and collection.
• To assess the feasibility and tolerability of the Mini-ICE regimen in adult AML patients previously treated with fludarabine.

Main Methods:

• Seven adult AML patients who received fludarabine-based regimens were treated with a low-dose 5-day Mini-ICE regimen (oral idarubicin and etoposide; subcutaneous cytosine arabinoside).
• Leukapheresis was initiated when CD34+ cell counts exceeded 10/microL.
• Collected PBSC were used for autologous transplantation.

Main Results:

• The Mini-ICE regimen successfully mobilized and collected a median of 8.1 x 10(6) CD34+ cells/kg.
• All patients underwent successful autologous PBSC transplantation.
• Patients experienced rapid neutrophil and platelet recovery with normal transfusional support.

Conclusions:

• The low-dose Mini-ICE regimen is a feasible, well-tolerated, and effective strategy for PBSC mobilization and collection in AML patients with low yields after fludarabine treatment.
• This approach may expand therapeutic options for autologous PBSC transplantation in heavily pretreated hematological malignancies.