Engraftment with peripheral blood stem cells collected by large-volume leukapheresis for patients with lymphoma.
Seven patients with refractory lymphomas underwent marrow reconstitution with peripheral blood stem cells (PBSCs) harvested by large-volume leukapheresis (LVL). PBSCs were collected from all patients more than 1 month after the last cycle of chemotherapy, and no patient received growth factors. The median number of LVL procedures performed per patient was 4.5, with a mean volume of 24.5 L of blood processed per procedure to obtain 7 x 10(8) mononuclear cells per kg. Autologous PBSCs and platelets were frozen at a controlled rate in plasma and 10-percent dimethyl sulfoxide and stored in the vapor phase of liquid nitrogen. This group of patients was compared to a control group (n = 18) who received medullary marrow (MM) transplants for the same diagnoses under the same protocols during the same period. Posttransplant days to white cell engraftment (PBSC = 17, MM = 15.5) were no different. Days to platelet independence were significantly longer in the LVL PBSC group (PBSC = 33, MM = 16; p < 0.05). This pattern of engraftment is typical of patients treated in this manner. Although Day 0 platelet counts (PBSC = 75.5 x 10(9)/L, MM = 85 x 10(9)/L) and total single-donor unit platelet use (PBSC = 8, MM = 9) were no different, Day 1 platelet counts (PBSC = 128 x 10(9)/L, MM = 61.5 x 10(9)/L; p < 0.05) and Day 14 platelet use (PBSC = 5, MM = 8; p < 0.05) were significantly different, because of the transfusion of cryopreserved autologous platelets with PBSCs on Day 0.
Comenzo
R L
RL
Bone Marrow Transplant Unit, Tufts University School of Medicine, Boston, Massachusetts.
Malachowski
M E
ME
Miller
K B
KB
Erban
J J
JJ
Schenkein
D P
DP
Desforges
J F
JF
Berkman
E M
EM
D000293:Adolescent; D000328:Adult; D001854:Bone Marrow Cells; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D008223:Lymphoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged