[Intensive chemotherapy with support of peripheral hematopoietic progenitor cells, mobilized with high-dose cyclophosphamide and G-CSF: fast hematologic recovery].
BACKGROUND
Hematopoietic progenitor cells mobilized to peripheral blood by a chemotherapy combined or not with hematopoietic growth factors and harvested with cyto-apheresis (CTA) provide a rapid hematological recovery when infused as a support step after intensive chemotherapy (IC).


METHODS
Cyclophosphamide (CI) 4 g/m2 and G-CSF 5 mcg/kg/d were administered to 19 patients with a solid tumor or lymphoma. Daily CTA were performed during hematological recovery to harvest > 2.5 x 10(6) cells CD34+/kg. Seventeen patients received IC with infusion of peripheral hematopoietic progenitor cells (PHPC) and G-CSF.


RESULTS
A total of 52 CTA were performed, with a median (M) of 2 per patient. A M of 4.4 x 10(8) mononucleated cells/kg and 9.8 x 10(6) CD34+/kg were harvested per patient. Hematological recovery after IC with support of PHPC and G-CSF was rapid in all cases, but the aplastic period was shorter in the ten patients who received > 5 x 10(6) CD34+/kg cells than in the seven patients with < 5 x 10(6) kg: The median of recovery to neutrophils > 0.5 x 10(9)/l was 8 days compared with 9 days (p = 0.0005), to platelets > 20 x 10(9)/l of 8 days compared with 12 days (p = 0.001), and to platelets > 50 x 10(9)/l of 11 days compared with 14 days (p = 0.001).


CONCLUSIONS
Toxicity of IC (4 g/m2) with G-CSF is moderate and allows the harvesting of an adequate number of PHPC. Its infusion after IC provides a rapid hematological recovery, which was more marked in patients receiving 5 x 10(6) CD34+/kg cells, than with the same IC schedules of IC with autologous bone marrow transplantation.
Sola
C
C
Departamento de Oncología, Servicio de Oncología Médica, Hospital de San Pablo, Barcelona.
Mendoza
L
L
Amill
B
B
Mesía
R
R
Rueda
A
A
Alonso
M C
MC
Ojeda
B
B
Artigas
V
V
Tugues
D
D
García
J
J
D000328:Adult; D001781:Blood Component Removal / Q000379:methods; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage*; D015672:Erythroid Precursor Cells; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000628:therapy*; D013997:Time Factors
D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003520:Cyclophosphamide
Quimioterapia intensiva con soporte de células progenitoras hematopoyéticas periféricas, movilizadas con ciclofosfamida a dosis altas y G-CSF: rápida recuperación hematológica.