Optimising parameters for peripheral blood leukapheresis after r-metHuG-CSF (filgrastim) and r-metHuSCF (ancestim) in patients with multiple myeloma: a temporal analysis of CD34+ absolute counts and subsets

Chin‐Yee, Ian; Keeney, Michael; Stewart, A. Keith; Belch, Andrew R.; Bence-Buckler, I; Couban, Stephen; Howson‐Jan, Kang; Rubinger, Morel; Douglas, Stewart; Sutherland, Robert; Paragamian, V; Bhatia, Mickie; Foley, Ronan

doi:10.1038/sj.bmt.1703765

Cited by 11 publications

(8 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, PBSCs can be harvested without the use of general anesthesia. Studies were conceived and are in progress to determine the optimal mobilization regimens that will permit the achievement of the necessary CD34 + cell thresholds with only one or two aphereses [4][5][6]. Following G-CSF-supported mobilization CT, CD34 + cell harvests may differ interindividually by more than 100-fold [7,8].…”

Section: Introductionmentioning

confidence: 99%

Kinetics of Peripheral Blood Stem Cell Mobilization Following G‐CSF‐Supported Chemotherapy

Seggewiss

Buss

Herrmann³

et al. 2003

STEM CELLS

View full text Add to dashboard Cite

It would be a clinical and economical advantage if the optimal time point of peripheral blood stem cell (PBSC) mobilization following G-CSF-supported chemotherapy (CT) was known in advance. Therefore, we retrospectively analyzed mobilization parameters in 113 adult tumor patients treated in our institution within 1 year. The start of apheresis was guided by CD34 + cell measurements in the PB and occurred on or after day 11 after start of mobilization CT in 97% of patients. The median peak (p)CD34 + cell count in PB uniformly occurred on day 14-15 (range: 6-32 days) after the start of CT, irrespective of the diagnosis (multiple myeloma n = 76, other histology n = 37), the type, but not the amount, of premobilization CT or radiotherapy (RT), the mobilization regimen, or the G-CSF dosage administered. Among more heavily pretreated patients (>six cycles of prior CT or RT), a higher proportion mobilized late (pCD34 + cell count later than day 20 in 12% and 13%, respectively, versus 2%-5% in the other groups). Therefore, we propose to start measuring CD34 + cells in the PB on day 11 after the start of mobilization therapy. The wide range of optimal mobilization time points argues for an individualized rather than a preset start of apheresis.

show abstract

Section: Introductionmentioning

confidence: 99%

Kinetics of Peripheral Blood Stem Cell Mobilization Following G‐CSF‐Supported Chemotherapy

Seggewiss

Buss

Herrmann³

et al. 2003

STEM CELLS

View full text Add to dashboard Cite

show abstract

“…15 A higher success rate was reported in two small subgroups of heavily pretreated patients. 16,17 Dawson et al 18 reported a 38% success rate in poorly mobilizing patients treated for malignant blood diseases, mostly lymphoid neoplasms. Herbert et al 19 Ancestim (r-metHuSCF) for poorly mobilizing patients V Lapierre et al lymphoid leukaemia who were previously treated with fludarabine.…”

Section: Discussionmentioning

confidence: 99%

“…In all, 57% of patients received ancestim combined with filgrastim (10 mg/kg/day) for a median of 6 days (range: 2-21); the Ancestim (r-metHuSCF) for poorly mobilizing patients V Lapierre et al other patients received chemotherapy followed by ancestim combined with filgrastim (5 mg/kg/day) for a median of 11 days (range: 1-33), similar to practices described in previous reports. 16 Biological monitoring of mobilization and peripheral blood collections Peripheral blood CD34 þ cell counts, aphereses and CD34 þ cell counts in collected cell products were determined at each of the 64 centres that reported data, according to local standard operating procedures. Our report summarizes results observed in individual cases and centres; thus, there was no attempt to standardize medical and laboratory practices in clinical, collection and processing facilities.…”

Section: Patientsmentioning

confidence: 99%

“…Nevertheless, subcutaneously administered SCF has been used in small series of poorly mobilizing patients, allowing autologous collection and transplantation in a proportion of these individuals, in association with antihistaminic and broncho-dilatators and under close clinical surveillance. [15][16][17][18][19][20] We report here the largest series of 513 poorly mobilizing adult patients, with a variety of malignancies, who received ancestim plus filgrastim following one or several previous failed attempts with G-CSF; French investigators took advantage of the compassionate program allowing access to this drug. We further report that SCF can be successfully and safely used in this subset of patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ancestim (r-metHuSCF) plus filgrastim and/or chemotherapy for mobilization of blood progenitors in 513 poorly mobilizing cancer patients: the French compassionate experience

Lapierre

Heshmati

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

Ancestim (r-MetHuSCF) is available in France for compassionate use in patients who are candidates for high-dose chemotherapy and autologous transplantation, and who failed in previous attempts at mobilization and collection. We report here data from 513 adult patients who benefited from this program, between January 1998 and July 2007. Given with systematic premedication, ancestim was generally well tolerated, although severe but not life-threatening adverse events were reported in 12 individuals. Overall, a graft was obtained or completed for 235 patients (46%). The median number of collected CD34 þ cells was 3.00 Â 10 6 /kg (range: 0.03-39.50). The target threshold of 2 Â 10 6 CD34 þ cells/kg was reached in 161 patients (31%). Factors associated with collection were diagnosis of myeloma, no previous autologous transplant, no more than one previous failed attempt and a mobilization regimen including cytotoxic agents. A total of 207 patients (40%) proceeded to high-dose chemotherapy and autologous transplantation. The median time to reach 0.5 Â 10 9 /L neutrophils and 20 Â 10 9 /L platelets was 12 (6-40) and 13 (0-31) days, respectively. We conclude that a combination of ancestim with filgrastim successfully mobilized CD34 þ cells in peripheral blood, and allowed adequate collection in preparation for autologous transplantation in approximately one-third of poorly mobilizing patients.

show abstract

“…41 G-CSF therapy following chemotherapy causes the rapid mobilization of progenitor myeloid cells from the bone marrow to aid in the repopulation of the immune cells destroyed by chemotherapy. 42 Consequently, this patient had high levels of CD34 ϩ progenitor cells mobilized into the peripheral blood by SCF and G-CSF therapy on day 11 after cyclophosphamide treatment, and these CD34 ϩ cells represented a rich source of BPI mRNA for polymerase chain reaction (PCR) amplification.Human BPI cDNA was generated and amplified by using a pair of primers (5Ј CCC GGG CCA CCA TGA GAG AGA ACA TGG CCA GG and 3Ј AAG CTT TCA TTT ATA GAC AAC GTC TGC AC) through reverse transcription (RT)-PCR of total cellular RNA extracted from the blood sample. The shuttle plasmid pDC104 containing a murine cytomegalovirus (CMV) promoter (523 bp), multicloning sites, and SV40 poly A signal (159 bp) inserted into the left end E1 region of human type 5 adenovirus genome was double-digested with SmaI and HindIII.…”

mentioning

confidence: 99%

Protection from endotoxemia by adenoviral-mediated gene transfer of human bactericidal/permeability-increasing protein

Alexander

Bramson

Foley

et al. 2004

Blood

View full text Add to dashboard Cite

Sepsis represents a growing concern in high-risk patients and there has been a lack of effective preventives and therapies. Bacterial/permeability increasing protein (BPI) is a human neutrophil granule-associated defense molecule specific for Gram-negative bacteria and their products. To develop a BPI-transgene-based prophylactic or therapeutic modality, we have developed a recombinant, replication-deficient adenoviral vector expressing full-length human BPI protein (Adh- BPI IntroductionSepsis is a heterogeneous condition with approximately 400 000 to 500 000 cases presented in the United States annually. 1,2 The mortality rate for all septic episodes is estimated between 30% to 50%, and approximately 70% of all septic episodes involve Gram-negative bacteria. 2,3 The Centers for Disease Control and Prevention has reported an increase in the incidence of sepsis over the last decade, which can be attributed to an increase in the number of patients at high risk for developing sepsis. 1 High-risk patients include those who are immunocompromised from HIV infection, undergoing cancer therapy, or on immunosuppressive drugs, and those undergoing invasive surgical procedures. These patients are at greater risk of exposure to bacteria, especially in the clinical setting. 4 The goal of sepsis management is to reduce or control the detrimental systemic inflammation responses to the infection using support therapies, while treatment therapies, such as antibiotics, attempt to eliminate the infection. 5 With the increase in incidence of both drug-resistant bacteria and immunocompromised septic patients, current aggressive therapies are ineffective or even detrimental, and new therapies must be developed to increase the survival of septic patients. 5-9 Moreover, it may be possible to prophylactically reduce the number of sepsis-induced mortalities by introducing a set of criteria to identify and treat high-risk individuals prior to surgery or cancer therapy.Various novel sepsis therapies currently under development or under evaluation in clinical trials include anticoagulant therapy, therapies directed at the neutralization of lipopolysaccharide (LPS), and cytokine therapies. Anticoagulant therapy aims to improve multiple organ failure by attenuating intravascular coagulation. 10 In this regard, the use of recombinant activated protein C has been shown to increase survival of patients. 10,11 However, activated protein C therapy addresses only one portion of the complex sepsis condition and does not address the important initial proinflammatory cytokine cascade elicited by LPS from Gram-negative bacteria. On the other hand, while therapies directed at the neutralization of proinflammatory cytokines, such as tumor necrosis factor ␣ (TNF-␣), are promising in experimental models, they are largely ineffective in clinical trials. 12-17 The interleukin-10 (IL-10) cytokine therapy aiming to counter the expression and effect of TNF-␣ has also proved ineffective. 18 Such cytokine therapies are thus unlikely to be the best strategy. Seps...

show abstract

Optimising parameters for peripheral blood leukapheresis after r-metHuG-CSF (filgrastim) and r-metHuSCF (ancestim) in patients with multiple myeloma: a temporal analysis of CD34+ absolute counts and subsets

Cited by 11 publications

References 51 publications

Kinetics of Peripheral Blood Stem Cell Mobilization Following G‐CSF‐Supported Chemotherapy

Kinetics of Peripheral Blood Stem Cell Mobilization Following G‐CSF‐Supported Chemotherapy

Ancestim (r-metHuSCF) plus filgrastim and/or chemotherapy for mobilization of blood progenitors in 513 poorly mobilizing cancer patients: the French compassionate experience

Protection from endotoxemia by adenoviral-mediated gene transfer of human bactericidal/permeability-increasing protein

Contact Info

Product

Resources

About