G‐CSF alone mobilizes sufficient peripheral blood CD34⁺ cells for positive selection in newly diagnosed patients with myeloma and lymphoma

Abstract

We have evaluated CD34+ cell positive selection from granulocyte-colony stimulating factor (G-CSF)-mobilized peripheral blood progenitor cells (PBPC) in 26 patients with either multiple myeloma (MM, n = 18) or follicular non-Hodgkin's lymphoma (NHL, n = 8). 26 PBPC were collected with two leukaphereses: 16 contained sufficient numbers of CD34+ cells and were elected. The absolute number of CD34+ cells in the leukapheresis products was found to be significantly related to the duration of underlying disease and exposure to prior treatment. CD34+ cell positive selection allowed recovery of a median of 35% of CD34+ cells, the selected fraction containing a median number of 1.43 x 10(6)/kg CD34+ cells/kg (range 0.48-41.5). 10 patients were transplanted and received a median dose of 1.51 x 10(6) CD34+ cells (range 0.48-4.2). The median time to granulocyte ( > 0.5 x 10(9)/l) and platelet ( > 20 x 10(9)/l) engraftment was 12 and 13 d respectively (ranges 10-13 and 0-95). Lymphoma cells were found by a sensitive polymerase chain reaction technique in four out of five CD34+ cell fractions tested.

Feasibility of a PB CD34+ cell transplantation procedure using standard leukapheresis products in very small children

“…3 Initial trials of autografts with CD34 ϩ PBSCs have mainly been performed in adult neuroblastoma weighing 20 kg or less. Products of two consecutive leukaphereses carried out on a COBE Specpatients [4][5][6] and, outside of our team, 7 and so thus far there have been no reports of studies performed in small children. tra separator after G-CSF alone mobilization were pooled for immunoselection on Ceprate column.…”

“…number of progenitor cells as about 50% of CD34 ϩ cells collected are presumed lost during the selection pro-CD34 ϩ cell immunoselection from G-CSF-alone primed PBSCs results in sufficient numbers of progenitor cells per cedure; [4][5][6][7]15,22 (2) the confirmation of the efficacy of selection technique (recovery rate, purity) in the light of differpatient kg to allow transplantation. The overall recovery of CD34 ϩ cells (45.3%) was in accordance with previously ent characteristics of the installed samples (overall cell concentration) when compared to adults; and (3) the sucreported data in adults.…”

Comparison of peripheral blood progenitor cell mobilization in patients with multiple myeloma: high-dose cyclophosphamide plus GM-CSF vs G-CSF alone

“…[22][23][24] I (18 patients) the progenitor cells were mobilized with highThis strategy has also been applied successfully as a PBPCdose cyclophosphamide (HD-CY), 4 g/m 2 i.v. divided in 2-priming regimen in patients with other poor-risk maligday infusions through a central venous catheter.…”

“…[25][26][27] Although some authors have pointed out the ration (4 l continuous infusion over 24 h) was initiated 12 h lower stem cell content provided by this approach when before chemotherapy. MESNA (Uromitexan; Asta Medica, compared with chemotherapy followed by cytokines, 28 other Madrid, Spain) was administered half an hour before the start investigators have found no significant differences [22][23][24][25][26] and of CY and continued for the following 24 h. In this group have suggested that PBPC mobilization with the use of a all patients were hospitalized during the administration of growth factor alone could be beneficial, avoiding unnecess-HD-CY and during the subsequent aplasia. ary hospitalization and toxicity during the secondary aplarhGM-CSF (Molgramostim, Sandoz SA/Scheringsia induced by HD-CY.…”

“…antibiotics during the neusuggest a lower rate of 'mobilizing failures' in myeloma patients after priming with chemotherapy but there are tropenic period, with two cases of documented septicemia one of them complicated with septic shock symptoms, and recent publications indicating that mobilization with a low dose of G-CSF alone is feasible in these patients. [22][23][24]34 six cases who required platelet support.…”