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Autologous transplantation in acute myeloid leukemia: peripheral blood stem cell harvest after mobilization in steady state by granulocyte colony-stimulating factor alone
- Source :
- Annals of Hematology. 80:584-591
- Publication Year :
- 2001
- Publisher :
- Springer Science and Business Media LLC, 2001.
-
Abstract
- In order to determine whether granulocyte colony-stimulating factor (G-CSF) alone initiated during steady state was able to mobilize peripheral blood stem cells (PBSC) in acute myeloid leukemia (AML) and to assess predictive factors for engraftment after autologous PBSC transplantation, we studied 49 successive adult AML patients for whom autologous transplantation was planned between July 1994 and November 1998. G-CSF was used as priming agent and was initiated at least 4 weeks after the last day of chemotherapy, while neutrophil count was0.5 x 10(9)/l and platelet count was30 x 10(9)/l. A median of three aphereses was performed resulting in a median collection of 14.8 x 10(8) nucleated cells/kg containing 7.7 x 10(8) mononuclear cells/kg, 47.1 x 10(4) CFU-GM/kg, and 3.8 x 10(6) CD34+ cells/kg. A significant correlation was observed between nucleated cell, mononuclear cell, and CFU-GM yields, while no correlation was found with CD34+ cell yield. Recruitment was not significantly different in patients with CD34+ leukemic cells at the time of initial diagnosis when compared to that of those presenting with CD34- blastic cells. Thirty-three patients actually underwent transplantation. Reasons for not autografting were inadequate stem cell harvest (ten patients), early relapse (two patients), prolonged neutropenia (one patient), organ failure (two patients), or patient refusal (one patient). Median time to achieve a neutrophil count greater than 0.5 x 10(9)/l and platelet count50 x 10(9)/l untransfused was 13 and 36 days, respectively. A predictive factor for a shorter period neutropenia and a shorter thrombopenia was a higher count of harvested nucleated cells (p0.01 and p = 0.02, respectively). A higher count of harvested cells was also a predictive factor for less red cell and platelet transfusions (p=0.03 and p=0.02, respectively). The number of CD34+ harvested PBSC was not predictive for engraftment. We conclude that PBSC mobilization with G-CSF alone initiated in steady state is a feasible, safe, and suitable procedure for harvesting cells in sight of autologous transplantation in adult acute myeloid leukemia.
- Subjects :
- medicine.medical_specialty
Neoplasm, Residual
Neutropenia
medicine.medical_treatment
Antigens, CD34
Hematopoietic stem cell transplantation
Transplantation, Autologous
Gastroenterology
Leukocyte Count
Recurrence
Internal medicine
Granulocyte Colony-Stimulating Factor
medicine
Humans
Autologous transplantation
Aged
Chromosome Aberrations
Platelet Count
business.industry
Macrophages
Graft Survival
Remission Induction
Hematopoietic Stem Cell Transplantation
Myeloid leukemia
Hematology
General Medicine
Middle Aged
Hematopoietic Stem Cells
Prognosis
medicine.disease
Thrombocytopenia
Granulocyte colony-stimulating factor
Transplantation
Leukemia, Myeloid, Acute
Karyotyping
Immunology
Tissue and Organ Harvesting
Absolute neutrophil count
Stem cell
business
Granulocytes
Subjects
Details
- ISSN :
- 14320584 and 09395555
- Volume :
- 80
- Database :
- OpenAIRE
- Journal :
- Annals of Hematology
- Accession number :
- edsair.doi.dedup.....dc0b55c74bc7a732d5754325e95eb492