Collection of Philadelphia-negative stem cells using recombinant human granulocyte colony-stimulating factor in chronic myeloid leukemia patients treated with alpha-interferon.
OBJECTIVE
Autologous stem cell transplantation is a therapeutic option for chronic myeloid leukemia (CML) patients who are not candidates for allogeneic transplant. To reduce the risk of post-autografting disease recurrence, different strategies of stem cell selection have been attempted. The results of using recombinant human granulocyte colony-stimulating factor (rHuG-CSF) for harvesting hematopoietic progenitors in CML patients treated with interferon-a (IFN) are reported.


METHODS
Twenty-one CML patients who received IFN for a median of 21 (8-68) months were mobilized with rHuG-CSF (10 mg/kg/day). Twelve were in complete (CCR) or major (MCR) cytogenetic response. Complete success was considered a sufficient harvest (> 1 x 10(6)/kg CD34(+) cells/kg) without Philadelphia (Ph)+ metaphases in at least one apheresis; a partial success was a sufficient harvest with 1-35% Ph(+) cells.


RESULTS
A total of 78 aphereses were performed. No patient had major side-effects. The median number (range) of mononuclear and CD34(+) cells obtained was, respectively, 8.6 x 10(8)/kg (0.9-22.6) and 3.3 x 10(6)/kg (0.4-26.3) per patient. A sufficient cell yield was collected in all but three patients. A complete/partial success was achieved in seven CCR/MCR patients (63%) and in three (33%) with other responses. Four patients underwent successful autografting using the stem cells obtained after rHuG-CSF mobilization.


CONCLUSIONS
Mobilization of IFN-treated patients using rHuG-CSF is safe and provides a significant proportion of Ph-negative progenitors in CML patients in complete or major cytogenetic response.
Hernández-Boluda
Juan-Carlos
JC
BMT Unit, Institute of Hematology and Oncology, Department of Hematology, Hospital del Mar, Villaroel 170, 08036 Barcelona, Spain.
Carreras
Enric
E
Cervantes
Francisco
F
Marín
Pedro
P
Arellano-Rodrigo
Eduardo
E
Rovira
Montserrat
M
Solé
Francesc
F
Lloveras
Elisabet
E
Espinet
Blanca
B
Ocejo
Agustín
A
Montserrat
Emili
E
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001772:Blood Cell Count; D001781:Blood Component Removal; D016465:Bone Marrow Purging / Q000379:methods* / Q000706:statistics & numerical data; D002066:Busulfan / Q000008:administration & dosage / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use*; D007372:Interferons / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood* / Q000188:drug therapy / Q000628:therapy; D007964:Leukocytosis / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D010146:Pain / Q000139:chemically induced; D010677:Philadelphia Chromosome; D011994:Recombinant Proteins; D012074:Remission Induction; D012449:Safety; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D007155:Immunologic Factors; D011994:Recombinant Proteins; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D007372:Interferons; D002066:Busulfan; D000069585:Filgrastim; D006918:Hydroxyurea