Although peripheral blood stem cell collections (PBSC) are thought to have less tumor involvement than bone marrow (BM), the incidence of circulating tumor cells in patients with breast cancer has not been widely investigated. We prospectively investigated the incidence and viability of tumor cell involvement in PBSC and BM collections from breast cancer patients undergoing high-dose chemotherapy/hematopoietic stem cell transplantation. Paired samples of PBSC and BM from 48 patients were analyzed using an immunocytochemical technique that detects one epithelial-derived tumor cell per 5 x 10(5) mononuclear cells. Immunostained tumor cells were detected in 9.8% (13/133) PBSC specimens from 9/48 (18.7%) patients and in 62.3% (38/61) BM specimens from 32/48 (66.7%) patients, a significantly higher rate than in PBSC (P < .005). The geometric mean concentration of tumor cells in contaminated PBSC specimens was 0.8/10(5) mononuclear cells (range 0.33 to 2.0/10(5)) compared with 22.9/10(5) mononuclear cells in BM (range 1 to 3,000/10(5), P < .0001). In culture experiments, clonogenic tumor colonies grew in 21/26 immunocytochemically positive specimens. No tumor colony growth was detected in 30/32 immunocytochemically negative specimens. Immunocytochemical detection of tumor involvement in BM and PBSC correlated significantly with in vitro clonogenic growth (P < .0001). We conclude that PBSC contain fewer tumor cells than paired BM specimens from patients with advanced breast cancer and that these tumor cells appear to be capable of clonogenic growth in vitro.
Summary:which may compromise the ability to mobilize hematopoietic progenitor cells and may result in delayed hematopoietic recovery, in particular thrombopoiesis, after myeloIn 29 consecutive heavily pretreated stage IV breast cancer patients, we analyzed patient factors and in vitro ablative therapy. 2,7,12 In prior studies, the number of mononuclear cells, CD34+ cells, or CFU-GM have been characteristics of peripheral blood progenitor cell (PBPC) collections that might correlate with the speed used with variable degrees of success to predict reliable engraftment of peripheral blood progenitor cells after highof hematopoietic recovery after autologous transplantation. PBPC collections were assessed for total number dose chemotherapy.
2,12-19Twenty-nine heavily pre-treated stage IV breast cancer of mononuclear cells infused/patient weight in kg and hematopoietic progenitor cell content using in vitro patients, who received peripheral blood progenitor cells as sole hematopoietic support after high-dose chemotherapy colony-forming assays. In these patients, who received PBPC as the sole hematopoietic support after myelowere the subject of this analysis. We observed significant variation in the tempo of platelet recovery and found that ablative chemotherapy, the number of erythroid burstforming units (BFU-E) infused correlated significantly the number of BFU-E infused accurately predicted time to both neutrophil and platelet recovery. with both time to neutrophil (P = 0.008) and platelet (P = 0.0001) recovery and was a better predictor of hematopoietic recovery than number of CFU-GM administered. By day 75 after transplantation, six patients with Patients and methods poor BFU-E yields failed to engraft platelets. Our data suggest that the number of BFU-E infused correlatePatient eligibility with time to hematopoietic engraftment and may Between
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