Cytokines alone for PBPC collection in patients with advanced gynaecological malignancies: G-CSF vs G-CSF plus EPO

Improving stem cell mobilization strategies: future directions

“…Studies evaluating the mobilization efficacy of EPO plus G-CSF or G-CSF alone in various doses have generated mixed results. Perillo et al 103 found that 3-4 daily concomitant doses of EPO 150 IU/kg s.c. plus G-CSF 5 mg/kg (n ¼ 5 patients) or 10 mg/kg (n ¼ 10 patients) s.c. conferred no mobilization benefit over administration of G-CSF alone (n ¼ 10 patients) in patients with advanced gynecological cancers. Olivieri et al 101 noted that CD34 þ cell yields obtained from 16 patients with NHL or other malignancies who received daily doses of EPO (50 U/kg s.c.) plus G-CSF (5 mg/kg s.c.) were 2.8 times greater than the yields obtained in 18 similar patients who received daily s.c. doses of 5 mg/kg G-CSF alone.…”

EPO in combination with G-CSF improves mobilization effectiveness after chemotherapy with ifosfamide, epirubicin and etoposide and reduces costs during mobilization and transplantation of autologous hematopoietic progenitor cells

“…17 To maximize the efficacy of stem cell collection-particularly in patients pretreated with chemotherapy in whom it may be difficult to attain the requested number of stem cells-and to reduce the necessary expenditures for treatment, a variety of cytokines (G-CSF þ SCF; G-CSF þ EPO) were used in clinical trials. 10,11,[18][19][20] Pierelli et al 10 showed in patients with ovarian cancer pretreated with epirubicin, paclitaxel and cisplatin that the collection of a higher number of CD34 þ cells with a lower number of necessary leukaphereses was achieved by the administration of G-CSF in combination with EPO compared with G-CSF alone. In the study of Oliveri et al 11 that comprised heavily pretreated patients suffering from mainly hematologic neoplasias, the number of CD34 þ cells could be enhanced by the additional use of EPO to G-CSF, but no effect on the number of leukaphereses was seen.…”

Collection and processing of marrow and blood hematopoietic stem cells

“…42 Both agents can cause bone pain, nausea, vomiting, diarrhea, insomnia, chills, fevers, and night sweats, 43 which account for the major risks associated with peripheral stem cell collection when compared to marrow harvest. 49,50 Stem cell factor 40,44 However, in poorly mobilizing patients, GM-CSF together with G-CSF have been shown to increase CD34+ yields and therefore may be of some benefi t in this population.…”