Febrile neutropenia does not affect collection of adequate cd34⁺ cells after mobilization with chemotherapy and g-csf

A retrospective analysis was performed to determine the effect of febrile neutropenia after mobilization with chemotherapy on the adequacy of peripheral blood stem cell (PBSC) collection. Between 20/02/95 and 10/03/97, 141 collections were obtained on 136 consecutive patients (92 myeloma, 28 breast cancer, 9 Non-Hodgkin's lymphoma, 7 others). All patients were mobilized with chemotherapy (139 Cyclophosphamide (CY)based, 2 other) and either G-CSF (122pts), GM-CSF (15pts), or both (4pts). Of the 140 analyzable pts, there were 38 (30%) documented episodes of febrile neutropenia. 13β8 pts (34.2%) with febrile neutropenia compared to 17/102 (16.67%) without febrile neutropenia had inadequate collections (p=0.024). An inadequate PBSC collection was defined as CFUGM<10xl04/kg and CD34<1.6xl06/kg. Median CFU-GM and CD34 were 35.82 (range 0-296) and 5.53 (range 0.16-221) vs 42.65 (range 0.24-607) and 6.09 (range 0.07-74.71), respectively. There was no significant difference between the 2 groups. By univariate analysis, the other predictors of inadequate collection were: prior melphalan exposure, >6 cycles of melphalan, prior radiotherapy to the spine/pelvis, and mobilization with GM-CSF. CY dose, age and the number of prior cycles of chemotherapy did not affect adequacy of collection. Mobilization with CY and GM-CSF (p=0.004) was the only variable predictive of inadequate PBSC collection using logistic regression analysis. Neither febrile neutropenia nor positive blood cultures in the febrile pts were independent predictors for inadequate collections. Autotransplants with PBSC were performed in 20β8 pts with and 60/103 pts without febrile neutropenia. Median days to ANC>500 and Plt>20 were similar in both groups (p=0.2 and p-4O.8). In conclusion, febrile neutropenia after mobilization with chemotherapy does not affect the adequacy of PBSC collection or engraftment.