A Randomized Study Comparing the Effects of G-CSF and G-CSF/GM-CSF for the Mobilization of Peripheral Blood Stem Cells by Mitoxantrone and High-Dose Cytarabine Chemotherapy

Abstract

We investigated the efficiency of mitoxantrone (MIT) and high-dose cytarabine (Ara-C) chemotherapy followed by G-CSF and G-CSF/GM-CSF treatments for the mobilization of peripheral blood stem cells (PBSCs) in patients with leukemia and lymphoma. MIT was intravenously injected at 10 mg/(m2·d) for 2 to 3 days, followed by Ara-C injected intravenously at 2 g/m2 every 12 hours for 1 to 2 days. When white blood cell count recovered from the lowest value, 5 to 7.5 μg/ (kg·d) G-CSF was administered in 23 patients for 5 to 7 successive days. Another 27 patients received 3-5 μg/ (kg·d) G-CSF and 3-5μg/ (kg·d) GM-CSF. Autologous peripheral blood mononuclear cells were collected. Levels of CFU-GM and CD34+ cells were determined after unfreezing. The CD34+ cells and CFU-GM yields of 27 patients in G-CSF plus GM-CSF combination group [(8.79±3.11)×106/kg, (3.52±1.34)×105/kg, respectively] were significantly higher than those of patients receiving G-CSF alone (n=23) [(6.14±2.06)×106/kg, (2.03±1.06)×105/kg, respectively (P < 0.05)]. No obvious changes of T lymphocyte subsets in patients were observed when using G-CSF/GM-CSF, but levels of CD34+ cells increased gradually (P>0.05). The end-point separation blood volume was all above trebling TBV. No severe complications were observed during the mobilization and collection. Autologous PBSCT obtained quick hematopoietic reconstitution. In conclusion, MA chemotherapy combined with G-CSF alone and G-CSF/GM-CSF can safely and effectively mobilize autologous PBSCs, while G-CSF plus GM-CSF is superior to G-CSF alone. Large volume leukapheresis is an important method to enhance the production rate of stem cells and decrease harvesting time.

Structure-Based Drug Design of ADRA2A Antagonists Derived from Yohimbine

“…Because the preparation of yohimbic acid esters by the above-described synthetic route using alcohols with the hydroxy group attached directly to a four-membered cycle proved to be problematic, a different synthetic approach was needed. N -Boc-protected amino alcohols were converted into alkylating agents using mesyl chloride and subsequently treated with the cesium salt of yohimbic acid ( 2 , Scheme ) according to described procedures. , Removal of protecting groups and reaction workup were performed in the same way as above. This approach afforded good yields of target compounds 4m – 4q (Scheme ), and their purification was also found to be easier.…”

“…N -Boc-protected amino alcohols were converted into alkylating agents using mesyl chloride and subsequently treated with the cesium salt of yohimbic acid ( 2 , Scheme 4 ) according to described procedures. 39 , 40 Removal of protecting groups and reaction workup were performed in the same way as above. This approach afforded good yields of target compounds 4m – 4q ( Scheme 4 ), and their purification was also found to be easier.…”