title: Immune mobilization of autologous blood progenitor cells: direct influence on the cellular subsets collected.
abstract: OBJECTIVE
  A phase I trial examined the ability of immunotherapy to mobilize progenitor and activated T cells.
  
  
  METHODS
  Interleukin (IL)-2 was administered subcutaneously for 11 days, with granulocyte (G)-colony-stimulating factor (CSF) (5 mcg/kg/day) and granulocyte-macrophage (GM)-CSF (7.5 mcg/kg/day) added for the last 5 days. Leukapheresis was initiated on day 11. Thirteen patients were treated (myeloma n = 11, non-Hodgkin's lymphoma n = 2).
  
  
  RESULTS
  Toxicities were minimal. IL-2 was stopped in two patients because of capillary leak (n = 1) and diarrhea (n = 1). Each patient required 2.5 leukaphereses (median; range 1-3) to collect 3.2 x 10⁶ CD34+ cells/kg (median; range 1.9-6.6 x 10⁶/kg). Immune mobilization increased the number of CD3+ CD8+ T cells (P = 0.002), CD56+ natural killer (NK) cells (P = 0.0001), CD8+ CD56+ T cells (P = 0.002) and CD4+ CD25+ cells (P = 0.0001) compared with cancer patients mobilized with G-CSF alone. There was increased lysis of myeloma cells after 7 days (P = 0.03) or 11 days (P = 0.02). The maximum tolerated dose of IL-2 was 1 x 10⁶ IU/m²/day.
  
  
  CONCLUSIONS
  Immune mobilization is well tolerated with normal subsequent marrow engraftment. As cells within the graft influence lymphocyte recovery, an increased number of functional lymphocytes may result in more rapid immune reconstitution.
authors.affiliation: Blood and Marrow Transplant Program, Section of Hematology and Oncology, 1 Medical Center Drive, Dartmouth Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, NH 03756, USA. Kenneth.R.Meehan@hitchcock.org
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Meehan
authors.forename: Laleh
authors.initials: L
authors.lastname: Talebian
authors.forename: Jillian
authors.initials: J
authors.lastname: Wu
authors.forename: John M
authors.initials: JM
authors.lastname: Hill
authors.forename: Zbigniew M
authors.initials: ZM
authors.lastname: Szczepiorkowski
authors.forename: Charles L
authors.initials: CL
authors.lastname: Sentman
authors.forename: Marc S
authors.initials: MS
authors.lastname: Ernstoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019559:Capillary Leak Syndrome / Q000209:etiology; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage; D019337:Hematologic Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage; D007937:Leukapheresis; D008213:Lymphocyte Activation; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D014182:Transplantation, Autologous
chemical_list: D007376:Interleukin-2; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor