Autologous blood progenitor cell transplantation in relapsed Hodgkin's disease--the role of haematopoietic growth factors.
Thirty-seven patients with Hodgkin's disease in sensitive relapse were autografted using blood-derived haematopoietic progenitor cells. At the time of transplantation 22 patients were in complete remission and 15 patients in partial remission. Twenty-six patients were male and 11 female, with a median age of 31 years (range 21-52). The pre-transplant conditioning therapy consisted of cyclophosphamide, BCNU and etoposide (CBV). Five patients died of transplant-related complications and 11 patients relapsed after a median time of four months following autografting. For the remaining 21 patients the probability of event-free survival (EFS) was 45% at 68 months. Blood progenitor cell collection can be integrated into salvage therapy by administering haematopoietic growth factors (HGFs) to enhance the chemotherapy-induced progenitor cell rebound during leucocyte recovery. In a subgroup of 14 patients, seven received recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) (250 micrograms/m2/day) by continuous intravenous infusion following dexamethasone, BCNU, etoposide and melphalan (Dexa-BEAM) as salvage therapy, while seven patients were treated without haematopoietic growth factor (HGF) post-chemotherapy. The yield of total nucleated cells (TNC) and granulocyte-macrophage colonies (CFU-GM) collected per leukapheresis was 2.2- and 2.4-fold higher respectively in the rhGM-CSF-treated patients. Following high-dose conditioning therapy, the seven patients autografted with rhGM-CSF-mobilised stem cells showed a faster leucocyte recovery compared with the control group. Neutrophil recovery (> 1.0 x 10(9)/L) and platelet recovery (> 20 x 10(9)/L) were also accelerated in the rhGM-CSF-treated group.(ABSTRACT TRUNCATED AT 250 WORDS)
Haas
R
R
Department of Internal Medicine V, University of Heidelberg, Germany.
Hohaus
S
S
Ehrhardt
R
R
Goldschmidt
H
H
Hunstein
W
W
D000328:Adult; D003115:Colony-Stimulating Factors / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D015996:Survival Rate
D003115:Colony-Stimulating Factors; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D000069585:Filgrastim