G-CSF and GM-CSF enhance the rate of neutrophil engraftment in autologous bone marrow transplantation (ABMT) without significantly affecting platelet engraftment. Peripheral blood progenitor cells (PBPC) may enhance rates of engraftment of both neutrophils and platelets. We treated 49 patients undergoing ABMT with a course of G-CSF to obtain PBPC and infused these cells post-transplant with G-CSF in an attempt to determine factors which might correlate with enhanced BM engraftment. Forty-nine patients with Hodgkin's disease, non-Hodgkin's lymphoma or breast cancer undergoing unpurged ABMT were studied. G-CSF priming consisted of an outpatient 8 day course of 5 μg/kg/day followed by three leukaphereses (on day 5, 7 and 8) to collect PBPC. Patients then received a chemotherapeutic BMT preparative regimen followed by an infusion of PBPC, autologous BM and the reinstitution of G-CSF (16 μg/kg/day). BM engraftment was rapid. The median time to achieve 0.5 x 109/l neutrophils was 10 days compared with a historical BMT control patient population receiving the same preparative regimens of 19 days (p = 0.001). Time to achieve a platelet count of 20 x 109/l was 16 days compared with a historical control of 22 days (p = 0.001). Neutrophil engraftment occurred in all patients by day +14. Marrow engraftment correlated with the total number of CD34+ cells infused as well as the total number of mononuclear cells infused but not the total number of CD34+/CD33- cells infused. The amount of total blood volume pheresed significantly correlated with yield of total mononuclear cells. Prior exposure to radiation therapy negatively correlated with progenitor cell yield. The rapid marrow engraftment resulted in an average total hospital stay of 29 days compared with a historical control of 39 days (p = 0.01). To date, relapse rates of the two study groups have been similar. These data suggest that treatment with G-CSF can result in excellent mobilization of PBPC. Furthermore, the addition of G-CSF primed PBPC plus G-CSF with autologous marrow in ABMT enhances both platelet and neutrophil engraftment rates which ultimately leads to a decreased total hospital stay.
|Original language||English (US)|
|Number of pages||6|
|Journal||Bone Marrow Transplantation|
|State||Published - 1993|
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