Intermediate-High-Dose Cyclophosphamide for Stem Cell Mobilization in Lymphoma: A Single-Center Retrospective Study

Intermediate-high-dose cyclophosphamide (Cy) (defined as ≥ 3 g/m²) has been shown to enhance the efficacy of stem cell mobilization. However, the associated side effects, particularly the risk of severe neutropenia, warrant careful consideration. We retrospectively analyzed 81 lymphoma patients who underwent peripheral blood stem cell (PBSC) mobilization between April 2020 and August 2022. Fifty-five patients received Cy (3 g/m²) plus colony-stimulating factor (G-CSF) and 26 patients received Cy (4 g/m²) plus G-CSF. The success rate of mobilization, defined as the collection of ≥ 2.0 × 10⁶ CD34⁺ cells/kg, was comparable between the two groups (83.6% vs. 88.4%, p = 0.568). However, the Cy (4 g/m²) group exhibited significantly lower minimum values of leukocytes, hemoglobin, and platelets during mobilization ( p  < 0.05). Additionally, the incidence of fever and hospitalization costs during stem cell harvest were significantly higher in the Cy (4 g/m²) group ( p  < 0.05). No significant differences were observed in neutrophil or platelet engraftment post-transfusion between the two groups. Our results showed that the mobilization scheme of cyclophosphamide (3 g/m²) combined with G-CSF can be a practical and safe mobilization strategy in clinical practice, since it demonstrated comparable efficacy and superior safety profiles in lymphoma patients undergoing PBSC mobilization.