Predictors for optimal mobilization and subsequent engraftment of peripheral blood progenitor cells following intermediate dose cyclophosphamide and G-CSF.
Fifty consecutive patients undergoing cyclophosphamide/G-CSF mobilization were studied for indicators predictive for adequate harvest (CD34+ cells > 2 x 10(6)/kg, CFU-GM > 1 x 10(5)/kg). Target yields following a single leukopheresis were achieved for 66% of patients (89% with no previous alkylation chemotherapy or radiotherapy). Previous alkylation therapy, radiotherapy and low collection day platelet count were predictive of poor collection yields. Following reinfusion, the median time to platelets > 20 x 10(9)/l (PLT > 20) was 10 days and to neutrophils > 500 x 10(6)/l (ANC > 500) was 13 days. Total CD34+ cells infused was predictive of early platelet engraftment. Previous radiotherapy was inversely predictive of neutrophil engraftment. For the majority of patients not exposed to alkylation therapy or radiotherapy, adequate progenitor cells can be collected following a single leukopheresis. In patients suitable for future autologous bone marrow transplantation it would seem appropriate to avoid or minimize radiotherapy and alkylation therapy exposure in the pre-collection period.
Morton
J
J
Bone Marrow Transplantation Unit, Royal Brisbane Hospital, Herston, Australia.
Morton
A
A
Bird
R
R
Hutchins
C
C
Durrant
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D018906:Antineoplastic Agents, Alkylating / Q000494:pharmacology; D002452:Cell Count; D000075202:Contraindications; D003520:Cyclophosphamide / Q000494:pharmacology; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects* / Q000276:immunology / Q000528:radiation effects*; D006801:Humans; D007937:Leukapheresis; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects / Q000528:radiation effects; D011994:Recombinant Proteins; D014182:Transplantation, Autologous
D018952:Antigens, CD34; D018906:Antineoplastic Agents, Alkylating; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; D000069585:Filgrastim