Hypercholesterolemia and its association with enhanced stem cell mobilization and harvest after high-dose cyclophosphamide plus G-CSF

High-dose chemotherapy with autologous peripheral blood SCT is a common treatment option in several hematological and non-hematological malignancies. So far, prediction of successful stem cell mobilization and harvest is limited. Just recently, hypercholesterolemia was shown to increase mobilization of hematopoietic progenitor cells into the peripheral circulation in mice. On the basis of these results, we performed a retrospective multivariate analysis incorporating a variety of clinical parameters in 83 patients following high-dose cyclophosphamide + G-CSF treatment. Interestingly, we found a significant positive correlation between stem cell mobilization and harvest for plasma cholesterol and lactate dehydrogenase (LDH) only. Patients with hypercholesterolemia showed a substantially higher median peripheral blood CD34(+)-peak (126 vs 47/mu L, P = 0.003), higher median number of harvested CD34(+)-cells/kg (9.6 vs 7.4 x 10(6)/kg, P<0.001) and a sufficient number for at least one SCT in a remarkably higher proportion (84.9 vs 52.9%, P = 0.003) compared with patients with normal cholesterol levels. Bone Marrow Transplantation (2011) 46, 1426-1429; doi:10.1038/bmt.2010.327; published online 10 January 2011