EFFECT OF PERIPHERAL-BLOOD PROGENITOR CELLS MOBILIZED BY FILGRASTIM (G-CSF) ON PLATELET RECOVERY AFTER HIGH-DOSE CHEMOTHERAPY

Sheridan, WP; Begley, CG; Juttner, CA; Szer, J; To, LB; MAHER, D; McGrath, KM; MORSTYN, G; Fox, RM

Author(s): Sheridan, WP; Begley, CG; Juttner, CA; Szer, J; To, LB; MAHER, D; McGrath, KM; MORSTYN, G; Fox, RM;
Details: Publication Year 1992-03-14,Volume 339,Issue #8794,Page 640-644
Journal Title: LANCET
Publication Type: Journal Article
Abstract: The haemopoietic growth factor granulocyte colony-stimulating factor (G-CSF; filgrastim) substantially shortens the period of severe neutropenia that follows high-dose chemotherapy and autologous bone-marrow infusion by stimulating granulopoiesis. Filgrastim also increases numbers of circulating progenitor cells. We have studied the ability of filgrastim to mobilise peripheral-blood progenitor cells and assessed their efficacy when infused after chemotherapy on recovery of neutrophil and platelet counts. 17 patients with non-myeloid malignant disorders received filgrastim (12-mu-g/kg daily for 6 days) by continuous subcutaneous infusion. Numbers of granulocyte-macrophage progenitors in peripheral-blood increased a median of 58-fold over pretreatment values, and numbers of erythroid progenitors increased a median of 24-fold. Three leucapheresis procedures collected a mean total of 33 (SEM 5.7) x 10(4) granulocyte-macrophage progenitors per kg body weight. After high-dose chemotherapy in 14 of the patients (busulphan and cyclophosphamide), these cells were used to augment autologous bone-marrow rescue and posttransplant filgrastim treatment. Platelet recovery was significantly faster in these patients than in controls who received the same treatment apart from the infusion of peripheral-blood progenitors; the platelet count reached 50 x 10(9)/l a median of 15 days after infusion of haemopoietic cells in the study patients compared with 39 days in controls (p = 0.0006). The accelerated neutrophil recovery associated with filgrastim treatment after chemotherapy was maintained. This method may be widely applicable to aid both neutrophil and platelet recovery after high-dose chemotherapy; it will allow investigation of peripheral-blood progenitor-cell allotransplantation.
Publisher: LANCET LTD
Keywords: COLONY-STIMULATING FACTOR; BONE-MARROW TRANSPLANTATION; HEMATOPOIETIC STEM-CELLS; NON-LYMPHOBLASTIC LEUKEMIA; NEUTROPHIL RECOVERY; EARLY REMISSION; GRANULOCYTE; MALIGNANCIES; RECONSTITUTION; COLLECTION
Publisher's Version: https://doi.org/10.1016/0140-6736(92)90795-5
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 1992-03-14 12:00:00