G-CSF-stimulated BM progenitor cells supplement suboptimal peripheral blood hematopoietic progenitor cell collections for auto transplantation.
Peripheral blood hematopoietic progenitor cells (PBHC) are the standard source of support for high-dose chemotherapy because of faster recovery of marrow function. Unfortunately, a proportion of patients are unable to mobilize adequate progenitors to proceed to autologous hematopoietic cell transplant (AHCT). Granulocyte-CSF-stimulated BM-derived hematopoietic progenitor cells (BMHC) may circumvent this problem. From 1999 to 2006, 52 patients (cases) with AML, Hodgkin (HL) or non-Hodgkin's lymphoma (NHL) in whom PBHC mobilization failed underwent a G-CSF-stimulated bone marrow harvest and proceeded to AHCT. Their outcome was compared with 422 patients (controls) with AML, HL and NHL undergoing AHCT using only PBHC. Twenty-three patients received BMHC alone and 29 patients received a combination of PBHC and BMHC. Median engraftment time for neutrophils (>0.5 x 10(9)/l) and platelets (>20 x 10(9)/l) were 14 and 27 days, but significantly longer when compared with controls (11 days, 11 days, P<0.0001). Patients receiving both PBHC and BMHC had faster engraftment, when compared with those receiving BMHC alone (P<0.001). In conclusion, performing an AHCT using G-CSF-stimulated BMHC in patients failing PBHC collection is feasible with faster engraftment seen in patients receiving both BMHC and PBHC over BMHC alone.
Seshadri
T
T
Department of Autologous Blood and Marrow Transplantation, Division of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada. tara.seshadri@uhn.on.ca
Al-Farsi
K
K
Stakiw
J
J
Ma
C
C
Saragosa
R
R
Franke
N
N
Keating
A
A
Crump
M
M
Kuruvilla
J
J
D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D019337:Hematologic Neoplasms / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D013234:Stem Cells / Q000166:cytology*; D013997:Time Factors; D016896:Treatment Outcome
D016179:Granulocyte Colony-Stimulating Factor