PHASE-II STUDY OF AUTOLOGOUS FILGRASTIM (G-CSF)-MOBILIZED PERIPHERAL-BLOOD PROGENITOR CELLS TO RESTORE HEMATOPOIESIS AFTER HIGH-DOSE CHEMOTHERAPY FOR LYMPHOID MALIGNANCIES
Details
Publication Year 1994-07,Volume 14,Issue #1,Page 105-111
Journal Title
BONE MARROW TRANSPLANTATION
Publication Type
Journal Article
Abstract
The hemopoietic growth factor filgrastim (r-metHu G-CSF) stimulates granulopoiesis after autologous BMT and can also be used as a peripheral blood progenitor cell (PBPC)-mobilizing agent. Rapid platelet recovery follows the addition of filgrastim-mobilized PBPC to autologous BMT. We have now studied 29 adults with malignant lymphoma, Hodgkin's disease or ALL to assess the ability of filgrastim-mobilized PBPC to rapidly and durably restore hemopoiesis without bone marrow (BM) infusion. Patients with a high yield of PBPC from three leukaphereses, defined as > 30 x 10(4)/kg GM-CFC, were eligible for PBPC transplant without BM. Patients with a low yield of GM-CFC received both PBPC and BM infusion. After filgrastim therapy 12 or 24 mu g/kg/day by continuous sc infusion for 6 or 7 days, a high yield was obtained in 11 of 29 patients. Kinetics of recovery of both the platelet and neutrophil counts were more rapid in the high yield group than in the low yield group. The platelet count recovered to > 20 x 10(9)/l at a median of 9 days, to > 50 x 10(9)/l at 11 days and the neutrophil count to > 0.5 x 10(9)/l at 9 days in the high yield group compared with 12 days, 37 days and 10 days, respectively, in the low yield group (p = 0.028, p < 0.001 and p = 0.027). Fewer platelet transfusions were required in the high yield group (median 11 vs 29.5 units, p = 0.021). All patients given infusions of filgrastim-mobilized PBPC without BM had durable hemopoietic recovery and none has required infusion of backup bone marrow in 11-25 months of follow-up.
Publisher
STOCKTON PRESS
Keywords
COLONY-STIMULATING FACTOR; BONE-MARROW TRANSPLANTATION; HEMATOPOIETIC STEM-CELLS; NON-LYMPHOBLASTIC LEUKEMIA; PLATELET RECOVERY; G-CSF; EARLY REMISSION; BREAST-CANCER; GRANULOCYTE; MOBILIZATION
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Creation Date: 1994-07-01 12:00:00
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