Hematological recovery and peripheral blood progenitor cell mobilization after induction chemotherapy and GM-CSF plus G-CSF in breast cancer

Abstract

Summary:In order to determine the effect of GM-CSF plus G-CSF in combination in breast cancer patients receiving an effective induction regimen, we compared hematological recovery and peripheral blood progenitor cell (PBPC) mobilization according to colony-stimulating factor (CSF) support. Forty-three breast cancer patients were treated by TNCF (THP-doxorubicin, vinorelbine, cyclophosphamide, fluorouracil, D1 to D4) with CSF support: 11 patients received GM-CSF (D5 to D14); 16 patients G-CSF (D5 to D14) and 16 patients GM-CSF (D5-D14) plus G-CSF (D10-D14). Between two subsequent cycles, progenitor cells were assessed daily, from D13 to D17. The WBC count was similar for patients receiving G-CSF alone or GM-CSF plus G-CSF, but significantly greater than that of patients receiving GM-CSF alone (P Ͻ 0.001). The GM-CSF plus G-CSF combination led to better PBPC mobilization, with significantly different kinetics (P Ͻ 0.001) and optimal mean values of CFU-GM, CD34 + cells and cells in cycle, at D15 compared to those obtained with G-CSF or GM-CSF alone. The significantly greater PBPC mobilization obtained with a CSF combination by D15 could be of value for PBPC collection and therapeutic reinjection after high-dose chemotherapies. Bone Marrow Transplantation (2000) 25, 705-710.

Early neutrophil engraftment following autologous BMT provides a functional predictor of long‐term hematopoietic reconstitution

“…Thus, quantitative assessment of CD34+ cells has become a useful method for determining the number of hematopoietic stem cells in a variety of clinical settings. These include determining the extent to which hematopoietic stem cells have been mobilized for peripheral collection and whether marrow or peripheral blood stem cell (PBSC) products contain adequate numbers of stem cells for hematopoietic reconstitution 5‐7 . Purification of CD34+ cells before transplantation has also become an accepted method for isolating stem cells and depleting other cells from the stem cell graft 8‐10 …”

Use of subgroup‐specific hematopoietic stem cell collection efficiencies to improve truncation calculations for large‐volume leukapheresis procedures

“…To achieve this, multiple algorithms of varying complexity have been developed to predict the minimum volume of blood that must be processed to meet the collection target. [14][15][16][17][18][19][20] The overwhelming majority of algorithms rely on two key values: the PB CD34 + cell count obtained at the start of the procedure, and the anticipated collection efficiency (CE) of the procedure.…”

“…Therefore, the goal of a successful collection series should be to minimize the number and length of procedures while still meeting the target CD34 + cell count. To achieve this, multiple algorithms of varying complexity have been developed to predict the minimum volume of blood that must be processed to meet the collection target 14‐20 . The overwhelming majority of algorithms rely on two key values: the PB CD34 + cell count obtained at the start of the procedure, and the anticipated collection efficiency (CE) of the procedure.…”

Low doses of GM-CSF (molgramostim) and G-CSF (filgrastim) after cyclophosphamide (4 g/m2) enhance the peripheral blood progenitor cell harvest: results of two randomized studies including 120 patients

“…[21][22][23] The synergistic effect of coadministration of HGFs like G-CSF and GM-CSF on PBPC mobilization has been suggested in phase I/II study, 24 for improving the harvest of CD34 cells. 25 Several non-randomized or randomized clinical trials have been performed, showing a little or no benefit for sequential administration of standard doses (5-10 mg/kg/d) of GM-CSF and G-CSF. [26][27][28][29][30][31][32][33][34][35][36][37] Neverthelesss, the use of these HGFs was not well explored and particularly the minimal efficient dose for their concomitant administration, following high dose cyclophosphamide (CY).…”