More efficient mobilisation of peripheral blood stem cells with HiDAC+AMSA+G-CSF than with mini-ICE+G-CSF in patients with AML: Progenitor Cell Mobilisation

We have compared the efficacy of two PBSC mobilisation regimens, mini-ICE+filgrastim (second consolidation) and HiDAC+AMSA+filgrastim (third consolidation), in two consecutive cohorts of patients with AML CR1 receiving treatment according to a joint protocol. Group A: 18 patients, aged 41 (21–65) years, were mobilised with mini-ICE (idarubicin 8 mg/m 2 +cytarabine 800 mg/m 2 +etoposide 150 mg/m 2 days 1–3) followed by filgrastim 300–480 μ g once daily s.c. from day 11 after start of chemotherapy. Only four patients reached >5 CD34+ cells/ μ l blood (B-CD34+) and were able to undergo leukaphereses. Two out of 18 (11%) reached the defined target of ⩾2.0 × 10 6 CD34+ cells/kg after 1–3 leukaphereses. Group B: 20 patients, aged 50 (29–67) years, received HiDAC+AMSA (cytarabine 3 g/m 2 b.i.d. days 1, 3, 5+amsacrine 150 mg/m 2 q.d. days 2, 4) followed by filgrastim at a similar dose starting on day 7. A total of 18 patients reached B-CD34+ >5/ μ l and underwent PBSC harvesting, starting on day 23 (14–29) and yielding 4.0 (0.9–21) × 10 6 CD34+ cells/kg. Of 20 patients, 17 (85%) reached the defined target of ⩾2.0 × 10 6 CD34+ cells/kg after 1–3 leukaphereses. We conclude that HiDAC+AMSA+G-CSF – in contrast to mini-ICE+G-CSF – is an efficient regimen for mobilising PBSC in patients with AML CR1.