Cyclophosphamide-mobilized peripheral blood stem cells in patient with lymphoid malignancies.
Mobilization of peripheral blood stem cells (PBSC) can be accomplished with cytokines or rebound from myelo-suppressive chemotherapy. In this study, patients were mobilized with cyclophosphamide (CY) 4 g/m2 either alone or followed by GM-CSF 250 micrograms/m2 or G-CSF 600 micrograms. Colony-stimulating factors were administered subcutaneously. Eligibility included patients with non-Hodgkin's lymphoma (NHL; n = 29), Hodgkin's disease (n 4) and acute lymphoblastic leukemia (n = 2). One patient died from mobilization-related complications. Admission for neutropenic fevers and other complications occurred in 73% of patients receiving CY alone compared with 32% received CY + G-CSF or GM-CSF (P < 0.05). Apheresis was initiated when the white blood count approached 1 x 10(9)/l and continued until approximately 6 x 10(8) mononuclear cells/kg were collected. Mobilization with CY + GM-CSF led to significantly greater numbers of collected CFU-GM than with CY alone. Colony-stimulating factors were not administered after transplantation. collected progenitor cells correlated with the peak cell counts after mobilization. Following transplantation, an ANC > = 500 x 10(6)/l was achieved at 14.5 days and a platelet count > = 50 x 10(6)/l was achieved on day 20. Days to achieve an ANC > = 500 x 10(6)/l did not correlate with any of the analyzed variables. Platelet engraftment correlated with harvested BFU-E, thawed CD34+ cells and peak counts following mobilization. for patients with NHL, CR was obtained in 82% of evaluable cases. Median time to relapse was 343 days. Twenty five per cent of patients remain disease-free at 900+ days of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
Rosenfeld
C S
CS
Western Pennsylvania Hospital, Western Pennsylvania Cancer Institute, Pittsburgh, USA.
Shadduck
R K
RK
Zeigler
Z R
ZR
Andrews
F
F
Nemunaitis
J
J
D000293:Adolescent; D000328:Adult; D003115:Colony-Stimulating Factors / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006098:Granulocytes / Q000187:drug effects*; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D007279:Injections, Subcutaneous; D008228:Lymphoma, Non-Hodgkin / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D008264:Macrophages / Q000187:drug effects*; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D012008:Recurrence; D013234:Stem Cells / Q000187:drug effects* / Q000473:pathology; D015996:Survival Rate
D003115:Colony-Stimulating Factors; D003520:Cyclophosphamide