Comparison of four cytokine regimens for mobilization of peripheral blood stem cells: IL-3 alone and combined with GM-CSF or G-CSF.
Improved methods for mobilization may reduce the number of aphereses required to collect adequate numbers of peripheral blood stem cells (PBSC) and hasten engraftment following high-dose therapy. Mobilization with cytokines alone enables engraftment after myeloablative therapy. The optimal cytokine regimen for mobilization has not been established. The study evaluated the effects of four interleukin-3-containing cytokine regimens administered during steady state hematopoiesis on PBSC mobilization in 30 patients with breast cancer or lymphoid malignancies. These regimens included IL-3 alone (Arm 1), sequential IL-3 --> G-GSF (Arm 2), sequential IL-3 --> GM-CSF (Arm 3) and combined IL-3 + G-CSF (Arm 4). Consecutive days of apheresis were performed until a target of 4-6 x 10(8) mononuclear cells/kg were collected. All patients received intravenous GM-CSF after PBSC infusion. Median days to an ANC > or = 500/ microliters in Arm 3(22 days) was significantly slower than for patients in Arm 2 (13 days) but not significantly different from patients in Arm 1 or Arm 4. There was no significant difference in platelet engraftment or days of hospitalization between the study arms. Addition of GM-CSF to IL-3-containing mobilization regimens results in collection of PBSC that lead to delayed engraftment. Further development of Arms 1, 2, and 4 appear warranted.
Rosenfeld
C S
CS
Texas Oncology, Professional Association, Dallas, USA.
Bolwell
B
B
LeFever
A
A
Taylor
R
R
List
A
A
Fay
J
J
Collins
R
R
Andrews
F
F
Pallansch
P
P
Schuster
M W
MW
Resta
D
D
Levitt
D
D
Nemunaitis
J
J
D000328:Adult; D001853:Bone Marrow / Q000187:drug effects* / Q000528:radiation effects; D001943:Breast Neoplasms / Q000097:blood; D002066:Busulfan / Q000494:pharmacology; D016190:Carboplatin / Q000494:pharmacology; D002330:Carmustine / Q000494:pharmacology; D003520:Cyclophosphamide / Q000494:pharmacology; D004334:Drug Administration Schedule; D004357:Drug Synergism; D005047:Etoposide / Q000494:pharmacology; D005260:Female; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects*; D006801:Humans; D007377:Interleukin-3 / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D007937:Leukapheresis; D007938:Leukemia / Q000097:blood; D007958:Leukocyte Count; D008223:Lymphoma / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011446:Prospective Studies; D013852:Thiotepa / Q000494:pharmacology; D014916:Whole-Body Irradiation
D007377:Interleukin-3; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003520:Cyclophosphamide; D013852:Thiotepa; D016190:Carboplatin; D002066:Busulfan; D002330:Carmustine