title: Mobilization and harvesting of peripheral blood stem cells: randomized evaluations of different doses of filgrastim.
abstract: The effects of different doses of filgrastim on yields of CD34+ peripheral blood stem cells were evaluated in patients with breast cancer. 55 were randomized to receive filgrastim 10, 20, 30 or 40 microg/kg/d with more CD34+ cells/kg/apheresis harvested after the three highest dose levels. 35 additional patients were randomized to receive 10 or 30 microg/ kg. The median number of CD34+ cells collected after 10 microg/ kg (n = 31) was 0.7 x 10(6)/kg/apheresis (range 0.1-4.4) as compared to 1.2 (range 0.1-6.8) after 30 microg/kg (n = 32) (P = 0.04). Among patients randomized to 10 v 30 microg/kg, more (50%) achieved > or = 5.0 x 10(6) CD34+ cells/kg and less aphereses were required to achieve > or = 2.5 x 10(6) CD34+ cells/kg after the higher dose (P = 0.04). In multivariate analyses, patients receiving 10 microg/kg (n = 31) had lower yields of CD34+ cells (P = 0.026) and had a 3.3-fold increase in the probability of not achieving > or = 5.0 x 10(6) CD34+ cells/kg as compared to patients receiving 20-40 microg/kg (n = 59). Patients who had received radiation had a 2.9-fold probability of not achieving > or = 2.5 x 10(6) CD34+ cells/kg. These data suggest that, in patients with good marrow reserves, doses of filgrastim > 10 microg/kg/d mobilized more CD34+ cells and may be useful when high numbers of CD34+ cells are desired.
authors.affiliation: Clinical Research Division of Response Oncology Inc., Memphis, Tennessee, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Weaver
authors.forename: R
authors.initials: R
authors.lastname: Birch
authors.forename: F A
authors.initials: FA
authors.lastname: Greco
authors.forename: L
authors.initials: L
authors.lastname: Schwartzberg
authors.forename: B
authors.initials: B
authors.lastname: McAneny
authors.forename: M
authors.initials: M
authors.lastname: Moore
authors.forename: D
authors.initials: D
authors.lastname: Oviatt
authors.forename: J
authors.initials: J
authors.lastname: Redmond
authors.forename: C
authors.initials: C
authors.lastname: George
authors.forename: T
authors.initials: T
authors.lastname: Alberico
authors.forename: P
authors.initials: P
authors.lastname: Johnson
authors.forename: C D
authors.initials: CD
authors.lastname: Buckner
mesh_terms: D018952:Antigens, CD34; D001943:Breast Neoplasms / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D005069:Evaluation Studies as Topic; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D011994:Recombinant Proteins
chemical_list: D018952:Antigens, CD34; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim