Peripheral Blood Stem Cells Mobilization with G-CSF (FILGRASTIM) Alone for Autologous Transplant in Myeloid and Lymphoid Malignancies
In order to determine whether granulocyte colony-stimulating factor (G-CSF) alone was capable of mobilizing peripheral blood stem cells (PBSC) in myeloid as well in lymphoid malignancies, G-CSF (filgrastim), 5 μg/kg/day, SC, was administered to 48 patients with myeloid or lymphoid malignancies at various stages, after hematopoietic recovery from last chemotherapy. PBSC were harvested using daily aphereses from day 5 of G-CSF therapy. An adequate PBSC graft could be harvested in 43 patients (90%) after 2 to 5 (median 3) aphereses. Predictive factors for a good PBSC yield in a multivariate analysis included a high WBC count on day 5 of G-CSF therapy, and a diagnosis of myeloid malignancy. Thirty patients were transplanted after various conditioning regimens. Median times to neutrophil > 0.5 x 109/1 and platelet > 50 x 109/1 were 15 and 32 days respectively. The harvest of > 10 x 104 CFU-GM/kg and the absence of busulfan in the conditioning regimen were predictive of early platelet recovery. We conclude that G-CSF therapy initiated during stable hematopoiesis is efficient to allow PBSC harvest for autografting in myeloid as well as lymphoid malignancies.
KeywordsAcute Myeloid Leukemia Acute Myeloid Leukemia Patient Conditioning Regimen Peripheral Blood Stem Cell Lymphoid Malignancy
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- 1.Chao NJ, Schriber JR, Grimes K, Long GD, Negrin RS, Raimondi CM, Horning SJ, Brown SL, Miller L, Blume KG. Granulocyte colony-stimulating factor “mobilized” peripheral blood progenitor cells accelerate granulocyte and platelet recovery after high-dose chemotherapy. Blood 81: 2031 – 2035, 1993.PubMedGoogle Scholar
- 5.Bensinger W, Singer J, Appelbaum F, Lilleby K, Longin K, Rowley S, Clarke E, Clift R, Hansen J, Shields T, Storb R, Weaver C, Weiden P, Buckner CD. Autologous transplantation with peripheral blood mononuclear cells collected after administration of recombinant granulocyte stimulating factor. Blood 81: 3158 - 3163, 1993.PubMedGoogle Scholar
- 6.Peters WP, Rosner G, Ross M, Vredenburgh J, Meisenberg B, Gilbert C, Kurtzberg J. Comparative effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) on priming peripheral blood progenitor cells for use with autologous bone marrow after high-dose chemotherapy. Blood 81: 1709 - 1719, 1993.PubMedGoogle Scholar
- 8.Sheridan WP, Begley CG, To LB, Grigg A, Szer J, Mäher D, Green MD, Rowlings PA, McGrath KM, Cebon J, Dyson P, Watson D, Bayly J, de Luca E, Tomita D, Hoffman E, Morstyn G, Juttner CA. Phase II study of autologous filgrastim (G-CSF)-mobilized peripheral blood progenitor cells to restore hemopoiesis after high-dose chemotherapy for lymphoid malignancies. Bone Marrow Transplant 14: 105 - 111, 1994.PubMedGoogle Scholar
- 10.Archimbaud E, Jehn U, De Cataldo F, Martin C, Thomas X. Idarubicin or mitoxantrone, VP-16 and cytarabine for induction/consolidation therapy followed by autologous stem cell transplantation in elderly patients with acute myeloid leukemia (AML): a feasibility study. Acute Leukemias VI, Prognostic Factors and Treatment Strategies. Ann Hematol 70 (suppl 2): A136, 1995.Google Scholar