Mobilization of peripheral blood progenitor cells following CHOP treatment combined with delayed granulocyte colony-stimulating factor administration in patients with non-Hodgkin's lymphoma.
The kinetic change in peripheral blood progenitor cells (PBPC) during 3 to 6 cycles of standard CHOP regimen supported with human recombinant granulocyte colony-stimulating factor (rG-CSF) was investigated in three patients with newly diagnosed intermediate grade, diffuse large cell type, non-Hodgkin's lymphoma (NHL) without bone marrow invasion. Patients were given rG-CSF subcutaneously (2 mu g/kg/day) initiated when total leukocytes was < 3.0 x 10(9)/1. When the leukocyte count remained at >3.0 x 10(9)/1, rG-CSF was started 10 days following the prior CHOP. Treatment with rG-CSF was discontinued after the leukocyte count reached >10.0 x 10(9)/1, and CHOP was started the next day (CHOP-G regimen). The number of PBPC was monitored by clonal assay in patients 1-3. No severe leukopenia with <0.5 x 10(9)/1 of neutrophils was seen in any patient. Colony-forming unit granulocyte-macrophage (CFU-GM) significantly increased after 2-3 days of consecutive administration of rG-CSF. The magnitudes of maximum amplification of CFU-GM in patients 1, 2, and 3, were 56-fold (during 3 cycles of CHOP-G), 216-fold (during 2 cycles), and 67-fold (during 4 cycles), respectively, and the absolute numbers of the maximum CFU-GM/ml blood were 983, 7,568, 9,865, respectively. In one patient who was given 6 cycles of CHOP-G, the peak values of mobilized CFU-GM in each cycle did not substantially decrease until 6 cycles of CHOP-G had been completed. Thus, the CHOP-G regimen described here seems to be very efficient increasing the circulating CFU-GM prior to harvesting PBPC.
Takano
H
H
Department of Medicine II, Hokkaido University School of Medicine, Hokkaido, Japan.
Sawada
K
K
Sato
N
N
Natoya
A
A
Tarumi
T
T
Hirayama
S
S
Koizumi
K
K
Takahashi
T A
TA
Sekiguchi
S
S
Koike
T
T
D000293:Adolescent; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology* / Q000627:therapeutic use; D001853:Bone Marrow / Q000187:drug effects*; D002465:Cell Movement / Q000187:drug effects; D003114:Colony-Forming Units Assay; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000494:pharmacology; D004317:Doxorubicin / Q000008:administration & dosage / Q000494:pharmacology; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology*; D006410:Hematopoiesis / Q000187:drug effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011241:Prednisone / Q000008:administration & dosage / Q000494:pharmacology; D011994:Recombinant Proteins; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage / Q000494:pharmacology
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D000069585:Filgrastim; D011241:Prednisone