Successful transplantation of peripheral blood stem cells mobilized by chemotherapy and a single dose of pegylated G-CSF in patients with multiple myeloma.
Following induction therapy and 4 g/m(2) cyclophosphamide, a single dose of 12 mg polyethyleneglycol-conjugated G-CSF (pegfilgrastim; n=12) or daily doses of unconjugated G-CSF (8.5 mug/kg/day) (n=12) were administered to myeloma patients. Pegfilgrastim was associated with an earlier leukocyte recovery (12 vs 14 days) and peripheral blood CD34+ cell peak (12 vs 15 days). The peripheral blood CD34+ cell peak was lower in the pegfilgrastim group (78 vs 111/mul). Following high-dose melphalan (200 mg/m(2)) and autografting, leukocyte and platelet reconstitution was similar in both groups and stable blood counts were observed 100 days post transplant. In summary, a single dose of pegfilgrastim after chemotherapy is capable of mobilizing a sufficient number of CD34+ cells for successful autografting with early engraftment and sustained hematological reconstitution in patients with myeloma. These data provide the basis for randomized studies evaluating the optimal dose and time of pegfilgrastim as well as long-term outcome in larger cohorts of patients.
Steidl
U
U
Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine University Duesseldorf, Duesseldorf, Germany. usteidl@bidmc.harvard.edu
Fenk
R
R
Bruns
I
I
Neumann
F
F
Kondakci
M
M
Hoyer
B
B
Gräf
T
T
Rohr
U-P
UP
Bork
S
S
Kronenwett
R
R
Haas
R
R
Kobbe
G
G
D000328:Adult; D018952:Antigens, CD34 / Q000096:biosynthesis; D001792:Blood Platelets / Q000166:cytology; D003520:Cyclophosphamide / Q000494:pharmacology; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000031:analogs & derivatives* / Q000378:metabolism* / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007700:Kinetics; D007937:Leukapheresis; D007962:Leukocytes / Q000166:cytology / Q000378:metabolism; D008297:Male; D008558:Melphalan / Q000494:pharmacology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000378:metabolism / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011092:Polyethylene Glycols / Q000378:metabolism; D011500:Protein Synthesis Inhibitors / Q000494:pharmacology; D011994:Recombinant Proteins; D033581:Stem Cell Transplantation / Q000379:methods*; D013234:Stem Cells / Q000166:cytology*; D013997:Time Factors
D018952:Antigens, CD34; D011500:Protein Synthesis Inhibitors; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D003520:Cyclophosphamide; D000069585:Filgrastim; D008558:Melphalan