Long-term marrow reconstitutive ability of autologous grafts in lymphoma patients using peripheral blood mobilized with granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor compared to bone marrow.
OBJECTIVE
The aim of this study was designed to compare the in vivo long-term hematopoietic potential of bone marrow and peripheral blood grafts.


METHODS
Marrow progenitor cell recovery was assessed for up to 4 years in 227 patients. One hundred patients were treated for malignant lymphomas by autologous bone marrow transplantation (BMT) and 127 by peripheral blood progenitor cell transplantation (PBPCT).


RESULTS
Marrow progenitor cell counts were decreased for several years with both bone marrow and peripheral blood grafts. They were not different according to the origin of the graft, despite the reduced duration of peripheral blood cell recovery observed after PBPCT. Granulocyte colony-stimulating factor (G-CSF) used for PB graft mobilization and after transplantation resulted in faster neutrophil recovery compared to granulocyte-macrophage colony-stimulating factor (GM-CSF) with no evidence of decreased marrow progenitor cell recoveries. On the other hand, postgraft administration of GM-CSF enhanced long-term colony-forming unit granulocyte-macrophage reconstitution only after BMT. Factors that influenced marrow progenitor cell reconstitution have been identified by univariate and multivariate analysis: age, gender, type of lymphoma, and postgraft administration of hematopoietic growth factors (HGF) for the whole patient group; gender, graft progenitor cell yields, and type of HGF (G-CSF vs GM-CSF) for the PBPCT group; and only type of HGF for the BMT group. Despite faster peripheral blood cell recovery, persistent deficiency of marrow progenitor cells was found several years after PBPCT, as observed after BMT. G-CSF-mobilized PBPCT resulted in faster neutrophil recovery compared to GM-CSF mobilization, with no difference in long-term hematopoietic reconstitution.
Benboubker
Lotfi
L
Laboratory of Hematology, UPRES-EA 3249, Faculty of Medicine and University Hospital of Tours, Tours, France.
Cartron
Guillaume
G
Roingeard
Françoise
F
Delain
Martine
M
Degenne
Michel
M
Linassier
Claude
C
Hérault
Olivier
O
Truglio
Danielle
D
Bout
Myrtille
M
Petit
André
A
Brémond
Jean Louis
JL
Desbois
Isabelle
I
Colombat
Philippe
P
Binet
Christian
C
Domenech
Jorge
J
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002648:Child; D003114:Colony-Forming Units Assay; D005260:Female; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology*; D006410:Hematopoiesis; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D006801:Humans; D007951:Leukemia, Myeloid / Q000209:etiology; D008223:Lymphoma / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D008297:Male; D009190:Myelodysplastic Syndromes / Q000209:etiology; D016609:Neoplasms, Second Primary / Q000209:etiology; D036102:Peripheral Blood Stem Cell Transplantation; D016879:Salvage Therapy; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor