title: Autologous transplantation of mobilized peripheral blood CD34+ cells selected by immunomagnetic procedures in patients with multiple myeloma.
abstract: In the use of autologous PBPC transplantation in patients with multiple myeloma, contamination of PBPC with myeloma cells is commonly observed. Enrichment for CD34+ cells has been employed as a method of reducing this contamination. In this study the reduction of myeloma cells in PBPC was accomplished by the positive selection of CD34+ cells using immunomagnetic bead separation (Isolex 300 system). PBPC were mobilized from 18 patients using cyclophosphamide (4.5 g/m2) and G-CSF (10 microg/kg/day). A median of two leukaphereses and one selection was performed per patient. The median number of mononuclear cells processed was 3.50 x 10(10) with a recovery of 1.11 x 10(8) cells after selection. The median recovery of CD34+ cells was 48% (range 17-78) and purity was 90% (29-99). The median log depletion of CD19+ cells was 3.0. IgH rearrangement, assessed by PCR, was undetectable in 13 of 24 evaluable CD34+ enriched products. Patients received 200 mg/m2 of melphalan followed by the infusion of a median of 2.91 x 10(6)/kg CD34+ cells (1.00-16.30). The median time to absolute neutrophil count >0.5 x 10(9)/l was 11 days, and sustained platelet recovery of >20 x 10(9)/l was 14 days. We conclude that immunomagnetic-based enrichment of CD34+ cells results in a marked reduction in myeloma cells without affecting engraftment kinetics.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.
authors.forename: R
authors.initials: R
authors.lastname: Abonour
authors.forename: K M
authors.initials: KM
authors.lastname: Scott
authors.forename: L A
authors.initials: LA
authors.lastname: Kunkel
authors.forename: M J
authors.initials: MJ
authors.lastname: Robertson
authors.forename: R
authors.initials: R
authors.lastname: Hromas
authors.forename: V
authors.initials: V
authors.lastname: Graves
authors.forename: E N
authors.initials: EN
authors.lastname: Lazaridis
authors.forename: L
authors.initials: L
authors.lastname: Cripe
authors.forename: V
authors.initials: V
authors.lastname: Gharpure
authors.forename: C M
authors.initials: CM
authors.lastname: Traycoff
authors.forename: B
authors.initials: B
authors.lastname: Mills
authors.forename: E F
authors.initials: EF
authors.lastname: Srour
authors.forename: K
authors.initials: K
authors.lastname: Cornetta
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D018189:Immunomagnetic Separation; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D016133:Polymerase Chain Reaction; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34; D018906:Antineoplastic Agents, Alkylating; D007143:Immunoglobulin Heavy Chains; D003520:Cyclophosphamide