Selection and immunomagnetic purging of peripheral blood CD34+ cells for autologous transplantation in B-cell non-Hodgkin's lymphomas.
BACKGROUND
Clonogenic tumor cells in the hematopoietic progenitor cell harvest may contribute to relapse after high dose therapy for B-cell malignancies. Purging of the HPC harvest requires large amounts of anti-B-cell antibodies, whereas CD34-selection enriches self renewing HPC's but malignant cells are still detectable in many CD34+ fractions.


METHODS
We examined the feasibility and safety of a CD34-selection followed by purging with anti B-cell antibodies in 11 patients with B-cell non-Hodgkin's lymphomas undergoing high-dose therapy with cyclophosphamide, BCNU and etoposide with retransfusion of autologous HPC's.


RESULTS
A mean number of 340 x 10(8) mononuclear cells was used for CD34-selection and immunomagnetic purging. CD34+ cells were enriched from a mean of 1.7% (range 0.2%-4.5%) to a mean of 68% (range 49%-87%) with a mean recovery of 27% (range 15%-43%). The mean number of retransfused CD34+ cells was 1.2 x 10(6)/kg (range 0.6-2.2 x 10(6)/kg) body weight with a median of 11 days (range 10-13 days) to neutrophil recovery of 0.5 x 10(9)/l and 17 days (range 13-25 days) to platelet recovery of 50 x 10(9)/l. Mean number of intravenous antibodies and inpatient days were 8 (range 0-14) and 22 (range 19-26) respectively. Major toxicity consisted in four septicemias.


CONCLUSIONS
CD34-selected and purged HPC's are safe and mediate rapid hematological recovery after high dose therapy for B-cell non-Hodgkin's lymphomas.
Pichert
G
G
Department of Medicine, University Hospital, Zürich, Switzerland. onkpib@usz.unizh.ch
Schmitter
D
D
Widmer
L
L
Jost
L M
LM
Kurrer
M O
MO
Maurer
R
R
Stahel
R A
RA
D000911:Antibodies, Monoclonal; D018952:Antigens, CD34 / Q000097:blood*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002469:Cell Separation; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D018189:Immunomagnetic Separation; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016393:Lymphoma, B-Cell / Q000276:immunology / Q000628:therapy*; D014182:Transplantation, Autologous
D000911:Antibodies, Monoclonal; D018952:Antigens, CD34; D007166:Immunosuppressive Agents