Practical applications for peripheral blood progenitor cells in the treatment of lymphomas and solid tumours.
Autologous blood progenitor cell (BPC) support is used in conjunction with high-dose chemotherapy regimens and also permits the use of increasing dose-intensity schedules of conventional cytotoxic chemotherapy. However, our understanding of the optimal BPC support to be used in these different conditions is incomplete. These difficulties result from the use of different BPC collection procedures in different centres, to different patient populations and considerable variability between patients. For such treatment to be cost effective, greater knowledge is required about the best way of achieving mobilisation, collection, storage and engraftment of BPC. The use of G-CSF in combination with chemotherapy can yield sufficient BPC at a single apheresis to achieve haematopoietic reconstitution after high-dose therapy. This was partly achieved by accurate prediction of the optimum timing of cell collection, which coincided with the early exponential increase in white blood cells (WBC) after the chemotherapy induced nadir. BPC in apheresis product or whole blood from patients primed with chemotherapy and filgrastim (G-CSF) were found to be viable for 48 hours when stored at 4 degrees C. Patients receiving multicyclic ifosfamide, carboplatin and etoposide (ICE) chemotherapy received BPC in apheresis product or whole blood, which had been stored at 4 degrees C, on day 3 of each treatment cycle. Such an approach allowed a 200% increase in dose intensity without any increase in toxicity or the need for supportive care. Optimal use of BPC support may increase the effectiveness of chemotherapy for the common solid tumours.
Pettengell
R
R
James Ewing Laboratory of Developmental Hematopoiesis, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
D002469:Cell Separation; D002470:Cell Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008223:Lymphoma / Q000628:therapy*; D009369:Neoplasms / Q000628:therapy*
D016179:Granulocyte Colony-Stimulating Factor