Ancestim (recombinant human stem cell factor, SCF) in association with filgrastim does not enhance chemotherapy and/or growth factor-induced peripheral blood progenitor cell (PBPC) mobilization in patients with a prior insufficient PBPC collection.
Up to a third of autologous transplantation candidates fail to mobilize hematopoietic progenitors into the peripheral blood with chemotherapy and/or growth factor treatment, thus requiring innovative mobilization strategies. In total, 20 cancer patients unable to provide adequate PBPC products after a previous mobilization attempt were treated with ancestim (20 microg/kg/day s.c.) and filgrastim (10 microg/kg/day s.c.). In 16 patients, the pre-study mobilization was with filgrastim alone. Eight patients underwent single large volume leukapheresis (LVL) and 12 multiple standard volume leukaphereses (SVL) in both mobilizations. Pairwise comparison of peripheral blood CD34(+) cell concentrations on the day of first leukapheresis failed to document synergism - median CD34(+)/microl of 3.2 (<0.1 to 15.4) and 4.5 (1-28.56) for the pre-study and on-study mobilizations (P = 0.79, sign test), and 4.2 (<0.1-15.4) and 5 (1-28.56), respectively, for the 16 patients previously mobilized with filgrastim alone (P = 1, sign test). The number of CD34(+) cells/kg collected per unit of blood volume (BV) processed was similar in both mobilizations - median 0.1 x 10(6)/kg/BV and 0.09 x 10(6)/kg/BV, respectively (P = 1, sign test). In this phase II study, the combination of ancestim and filgrastim did not allow adequate PBPC mobilization and collection in patients with a previous suboptimal PBPC collection.
da Silva
M G
MG
Bone Marrow Transplantation Unit, Instituto Português de Oncologia de Francisco Gentil, Rua Prof. Lima Basto, 1093 Lisboa, Portugal. jcoelho@ipolisboa.min-saude.pt
Pimentel
P
P
Carvalhais
A
A
Barbosa
I
I
Machado
A
A
Campilho
F
F
Sousa
S R
SR
Miranda
N
N
da Costa
F Leal
FL
Campos
A
A
Vaz
C P
CP
Antas
J
J
Passos-Coelho
J L
JL
D000328:Adult; D018952:Antigens, CD34 / Q000096:biosynthesis; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000737:chemistry* / Q000378:metabolism; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D007963:Leukocytes, Mononuclear / Q000166:cytology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D019089:Stem Cell Factor / Q000031:analogs & derivatives* / Q000737:chemistry* / Q000378:metabolism; D013234:Stem Cells / Q000166:cytology*; D013997:Time Factors; D014182:Transplantation, Autologous
D018952:Antigens, CD34; D011994:Recombinant Proteins; D019089:Stem Cell Factor; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim; C105861:ancestim