Peripheral blood progenitor cell transplantation: a single centre experience comparing two mobilisation regimens in 67 patients

Bone Marrow Transplant. 1996 Apr;17(4):503-7.

Abstract

Between June 1991 and January 1995 we performed 67 peripheral blood progenitor cell transplants (PBPCT). Ten patients (group 1) were mobilised with 7 gm/m2 of cyclophosphamide followed by daily G-CSF injections (5 micrograms/kg, subcutaneously). When the white cell count reached 1 x 10(9)/1 they were leukapheresed for 5 days. After stem cell infusion they received G-CSF (10 micrograms/kg/day) until the neutrophil count reached 1.5 x 10(9)/1. Fifty-six patients had PBPCs mobilised with 3 gm/m2 of cyclophosphamide followed by daily subcutaneous G-CSF (5 micrograms/kg) and PBPCs were harvested on 2 consecutive days, when the white cell count rose to 4 x 10(9)/1. After stem cell infusion this group did not receive G-CSF. In 47 of the 56 patients (group 2) adequate MNC (> or = 4 x 10(8)/kg) and/or CFU-GM (> or = 10 x 10(4)/kg) were obtained. Insufficient MNC and/or CFU-GM were obtained in 10 patients. They were therefore transplanted using a combination of bone marrow and peripheral blood progenitor cells (group 3). Overall 64 patients successfully engrafted. Median days to neutrophils > or = 0.5 x 10(9)/1 were 9 (range 8-13), 12 (range 8-25) and 11 (range 9-16) and to platelets > or = 50 x 10(9)/1 were 11 (range 9-23), 13 (range 9-90) and 16 (range 13-99) in groups 1, 2 and 3 respectively. Patients in group 1 had a faster neutrophil recovery than patients in group 2 (P = 0.0002). The three patients who failed to engraft all received a combination of autologous peripheral blood and bone marrow cells.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Amyloidosis / therapy
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Bone Marrow / drug effects*
  • Carmustine / administration & dosage
  • Cell Movement
  • Colony-Forming Units Assay
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / pharmacology*
  • Cytarabine / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / pharmacology*
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation*
  • Hematopoietic Stem Cells / drug effects*
  • Humans
  • Kidney Diseases / therapy
  • Leukapheresis
  • Leukocyte Count
  • Male
  • Melphalan / administration & dosage
  • Middle Aged
  • Neoplasms / drug therapy
  • Neoplasms / therapy
  • Podophyllotoxin / administration & dosage
  • Retrospective Studies
  • Thiotepa / administration & dosage
  • Transplantation Conditioning

Substances

  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Etoposide
  • Cyclophosphamide
  • Thiotepa
  • Podophyllotoxin
  • Melphalan
  • Carmustine

Supplementary concepts

  • BEAM protocol