[Harvesting of autologous peripheral blood stem cells following percutaneous isolated hepatic perfusion for patients with advanced hepatocellular carcinoma].
Percutaneous isolated hepatic perfusion (PIHP) using high-dose chemotherapeutic agents is highly effective for advanced hepatocellular carcinoma in comparison with conventional regional and systemic chemotherapies. However, bone marrow toxicities resulting from the first PIHP preclude additional second/third PIHP in some cases. In an attempt to increase safety of repeated PIHP, autologous peripheral blood stem cells (PBSC) were harvested after the first PIHP in nine patients with multiple hepatocellular carcinoma with administration of G-CSF. PBSCs were successfully harvested in only three patients with relatively well-preserved liver function, whereas PBSC harvests were unsatisfactory in the remaining six patients with highly impaired liver function. The possible reasons for this phenomenon may include hypofunction of bone marrow in cirrhotic patients, and an insufficient use of G-CSF in the present study. Alfa-fetoprotein-mRNA, determined by nested RT-PCR, was detected in six PBSCs, indicating frequent contamination of tumor cells. More precise studies are needed before clinical application of autologous stem cell infusion for patients with malignant hepatic tumors and impaired liver function.
Hyogo Red Cross Blood Center.
Yoman
Y
Fujioka
Katsuyasu
K
Saigo
Makoto
M
Hashimoto
Shunichi
S
Kumagai
Osamu
O
Horie
Tetsuya
T
Takahashi
Takumi
T
Fukumoto
Yonson
Y
Ku
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D010478:Chemotherapy, Cancer, Regional Perfusion; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis; D020858:Tissue and Organ Harvesting / Q000379:methods; D014182:Transplantation, Autologous; D000509:alpha-Fetoproteins / Q000235:genetics / Q000302:isolation & purification
D018952:Antigens, CD34; D000970:Antineoplastic Agents; D012333:RNA, Messenger; D000509:alpha-Fetoproteins; D016179:Granulocyte Colony-Stimulating Factor; D004317:Doxorubicin