Allogeneic peripheral blood progenitor cells mobilized by G-CSF (filgrastim) for a second transplant in a patient with acute myeloid leukemia in relapse.
A 25-year-old man with AML, who relapsed 21 months after his first allogeneic bone marrow transplant (BMT), underwent a second transplant with peripheral blood progenitor cells (PBPC) obtained from his HLA-identical sibling. The donor cells were collected through four aphereses after G-CSF mobilization with 5 micrograms/kg/d for 5 days. The patient received BAVC conditioning regimen followed by non-T cell-depleted PBPC. Successful engraftment occurred with rapid hematopoietic recovery (time to reach 0.5 x 10(9)/L neutrophils and 50 x 10(9) platelets/L was 15 and 19 days, respectively). A bone marrow aspirate on day +19 showed trilineage engraftment. Erythrocyte phenotype showed that erythropoiesis was of donor origin. The patient developed grade II acute GVHD that responded to prednisone. Seven months after PBPC transplantation he remains in complete remission, alive and well, with just limited chronic GVHD. Allogeneic peripheral blood progenitor cell transplantation may be considered a suitable alternative to marrow transplant.
Martínez
J A
JA
Bone Marrow Transplantation Unit, Hematology Service, Hospital Universitario La Fe, Valencia, Spain.
Picón
I
I
Carral
A
A
de la Rubia
J
J
Sanz
G F
GF
Sanz
M A
MA
D000208:Acute Disease; D000328:Adult; D016026:Bone Marrow Transplantation; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects*; D006801:Humans; D007951:Leukemia, Myeloid / Q000473:pathology / Q000628:therapy*; D008297:Male; D011994:Recombinant Proteins / Q000494:pharmacology; D012008:Recurrence; D013997:Time Factors
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim