[Suppressive effect of high-dose chemotherapy (HDC) on the clonal growth of grafted peripheral blood granulocyte progenitors is reduced 72 hours after completion of HDC].
Hematopoietic stem cells (HSC) transplantations are usually performed 24-48 hours after the end od high-dose chemotherapy (HDC). It is possible, however, that at that time the transplanted HSC can be affected by the administered drugs. We report the results obtained in 30 patients (pts) with hematological malignancies (multiple myeloma - 14, Hodgkin's disease -6, non-Hodgkin's lymphomas -4, chronic myeloid leukemia -6) treated with HDC with peripheral blood stem cell transplantation (PBSCT). The following HDC regimens were applied: melphalan - 14, Dexa-BEAM (dexamethasone, BCNU, etoposide, cytarabine, melphalan) - 10 and BuCy2 (busulfan, cyclophosphamide) - 6. To evaluate the impact of HDC on the growth ability of less /14/ and more /7/ mature CFU-GM, sera were taken directly before cytoreductive chemotherapy, on the last day of HDC (0 day) and on days 1, 2, 3, 4 and 5 after the end of HDC. After melphalan, for CFU-GM/14/ the following results were received: days 0 - 54 +/- 9, 1 - 55 +/- 9, 2 - 68 +/- 12, 3 - 82 +/- 10, 4 - 95 +/- 8,5 - 100 +/- 8% and for CFU-GM/7/: days 0 - 60 +/- 11, 1 - 59 +/- 8, 2 - 72 +/- 11, 3 - 80 +/- 7, 4 - 90 +/- 9, 5 - 105 +/- 7%, determined as a percentage of those obtained before HDC (100%). After Dexa-BEAM, for CFU-GM/14/: days 0 - 45 +/- 13, 1 - 49 +/- 8, 2 - 59 +/- 12, 3 - 85 +/- 15, 4 - 96 +/- 9, 5 - 106 +/- 11%, and for CFU-GM/7/: 0 - 43 +/- 15, 1 - 50 +/- 9, 2 - 63 +/- 11, 3 - 89 +/- 11, 4 - 98 +/- 11, 5 - 110 +/- 8%. In case of BuCy2, for CFU-GM/14/: days 0 - 55 +/- 13, 1 - 67 +/- 7, 2 - 69 +/- 15, 3 - 85 +/- 10, 4 - 103 +/- 12, 5 - 108 +/- 7% and for CFU-GM/7/: days 0 - 50 +/- 12, 1 - 71 +/- 6, 2 - 76 +/- 16, 3 - 98 +/- 9, 4 - 105 +/- 11, 5 - 101 +/- 8%. In all pts PBSCT were infused 72 hours after HDC. The median time to reach granulocytes > 0.5 G/l and >1.0 G/l was 12 (8-17) and 13 (9-18) days, respectively. The recovery of platelets >20.0 G/l and >50. 0 G/l occured after 17 (9-48) and 25 (11-54) days, respectively. We conclude that the suppressive effect of the sera taken on days 0-2 on the CFU-GM growth depends on the HDC-regimen. We have also shown that third day after completion of HDC is the optimal time for the infusion of HSC. The time of hematological reconstituton is related in all investigated pts and independently on the HDC-program (p>0.05).
Katedra i Klinika Hematologii i Chorób Rozrostowych Układu Krwiotwórczego AM im. K. Marcinkowskiego w Poznaniu.
Maria
M
Kozłowska-Skrzypczak
Janusz
J
Hansz
Krzysztof
K
Sawiński
Mieczysław
M
Komarnicki
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D049109:Cell Proliferation; D002999:Clone Cells; D003131:Combined Modality Therapy; D005260:Female; D042381:Granulocyte Precursor Cells / Q000187:drug effects* / Q000473:pathology; D019337:Hematologic Neoplasms / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning; D016896:Treatment Outcome