Results of an autologous noncryopreserved, unmanipulated peripheral blood hematopoietic stem cell transplant program: a single-institution, 10-year experience.
BACKGROUND
Methods to simplify the stem cell transplantation procedures are needed mainly in developing countries. We have previously shown that unprocessed leukapheresis material is useful to restore hematopoiesis after high-dose chemotherapy.


METHODS
Over a 10-year period in a private practice setting, we prospectively performed autotransplants using noncryopreserved and unmanipulated peripheral blood stem cells mobilized from the bone marrow to the peripheral blood by means of filgrastim and using a single-day conditioning regimen with high dose (200 mg/m2) melphalan.


RESULTS
Forty-six individuals were given 50 autografts. The median age of the patients was 33 years (range 8-69). Twenty-two patients with acute leukemia (13 with myeloblastic and 9 with lymphoblastic leukemia), 4 with chronic myelogenous leukemia, 6 with multiple myeloma, 7 with Hodgkin's disease, 3 with non-Hodgkin's lymphoma and 4 with metastatic breast carcinoma were included. The median time to achieve >0.5 x 10(9)/l granulocytes was 14 days (range 0-86), whereas the median time to achieve >20 x 10(9)/l platelets was 25 days (range 0-102). The 3,300-day posttransplant survival was 63%, the median posttransplant overall survival was over 3,300 days, the 3,300-day disease-free survival was 50% and the transplant-related mortality was 2%. The procedure was performed entirely on an outpatient basis in the case of 48 autografts (96%). The approximate cost of each graft was 7,500 USD.


CONCLUSIONS
This simplified method to autograft patients, avoiding in-hospital stays, purging procedures and cryopreservation of the cells, is feasible and results in a substantial decrease in the cost of the autologous hematopoietic stem cell transplantation methods.
Ruiz-Argüelles
Guillermo J
GJ
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico. gruiz1@clinicaruiz.com
Gómez-Rangel
David
D
Ruiz-Delgado
Guillermo J
GJ
Ruiz-Argüelles
Alejandro
A
Pérez-Romano
Beatriz
B
Rivadeneyra
Liliana
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015925:Cryopreservation; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D033581:Stem Cell Transplantation
D016179:Granulocyte Colony-Stimulating Factor