title: Durable and complete hematopoietic reconstitution after autografting of rhGM-CSF exposed peripheral blood progenitor cells.
abstract: Two patients with poor prognosis stage III multiple myeloma have been treated with myeloablative chemoradiotherapy, i.e. 10 Gy fractionated total body irradiation plus 120 mg/m2 intravenous melphalan, and then transplanted with autologous peripheral blood cells harvested by four leukaphereses during the phase of rapid hematopoietic recovery following induction therapy with high-dose (2 g/m2) etoposide and recombinant human glycosylated granulocyte macrophage-colony stimulating factor (rhGM-CSF). Following myeloablative therapy and autologous peripheral blood cell transplantation, both patients experienced brief pancytopenia followed by rapid hematopoietic recovery of leukocytes (time to greater than 500 x 10(6)/l = 12 days) and platelets (time to greater than 100 x 10(9)/l = 14 days). In particular, single donor platelet transfusion requirements were limited to one and two transfusions per patient, respectively. Reconstitution has so far been maintained throughout the follow-up period for the two patients (9 and 6 months, respectively). These two cases show that rhGM-CSF-exposed peripheral blood cells are capable of producing prompt and sustained hematopoietic reconstitution in patients treated with myeloablative chemoradiotherapy.
authors.affiliation: Cristina Gandini Transplantation Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Gianni
authors.forename: C
authors.initials: C
authors.lastname: Tarella
authors.forename: S
authors.initials: S
authors.lastname: Siena
authors.forename: M
authors.initials: M
authors.lastname: Bregni
authors.forename: M
authors.initials: M
authors.lastname: Boccadoro
authors.forename: F
authors.initials: F
authors.lastname: Lombardi
authors.forename: C
authors.initials: C
authors.lastname: Bengala
authors.forename: G
authors.initials: G
authors.lastname: Bonadonna
authors.forename: A
authors.initials: A
authors.lastname: Pileri
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001803:Blood Transfusion; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D016178:Granulocyte-Macrophage Colony-Stimulating Factor