Factors affecting hemopoietic recovery after high-dose therapy and autologous peripheral blood progenitor cell transplantation: a single center experience.

Background And Objective: While the minimum number of CD34+ cells required for complete and long-lasting engraftment is quite well established, there is not general agreement about the optimal number of CD34+ per kg needed in order to obtain engraftment as rapidly as possible. In the present study we assess factors affecting hemopoietic recovery and the optimal peripheral blood progenitor cell (PBPC) number for rapid engraftment in patients treated with high-dose therapy.

Design And Methods: We enrolled 80 consecutive patients affected by hematologic and non-hematologic malignancies treated with a median of 10 chemotherapy courses (range 3-38).

Addition of erythropoietin to granulocyte colony-stimulating factor after priming chemotherapy enhances hemopoietic progenitor mobilization.

Hemopoietic progenitor cell mobilization intended for autotransplantation is now feasible in many patients, following the administration of single cytokines (G-CSF, GM-CSF, IL-3) or their combination. Erythropoietin (EPO) is a cytokine which showed an interesting activity also on non-erythroid progenitors, however the clinical relevance of this activity has not been sufficiently investigated yet. This retrospective study has attempted to assess the effectiveness of the combination of EPO plus G-CSF after priming chemotherapy to increase the number of blood progenitor cells, as compared to the results obtained by G-CSF alone.

DHAP regimen plus G-CSF as salvage therapy and priming for blood progenitor cell collection in patients with poor prognosis lymphoma.

We studied 14 patients affected by lymphoma to assess the toxicity, efficacy and mobilization capability of salvage DHAP regimen followed by G-CSF 5 micrograms/kg/day. Ten patients were affected by intermediate-grade NHL and 4 by HD; all of them were in relapse or in PR. We administered a total of 34 courses of DHAP plus G-CSF (median 2 per patient; range 1-5) and did not observe either life-threatening extrahematologic toxicity or severe infections during the short neutropenic period.

Optimization of the yield of PBSC for autotransplantation mobilized by high-dose chemotherapy and G-CSF: proposal for a mathematical model.

We analyzed the results of 71 leukapheresis procedures performed in 21 patients to identify the best predictive factors affecting the yield of peripheral blood progenitors after high-dose chemotherapy followed by G-CSF administration. An average of 1 +/- 1 x 10(8) MNC/kg, 5 +/- 6 x 10(4) CFU-GM/kg and 4 +/- 6 x 10(6) CD34+ cells/kg was collected for each leukapheresis. When we defined > or = 5 x 10(4)/kg as the minimum number of CFU-GM per procedure for a 'satisfactory' collection, multiparameter analysis of clinical features and laboratory findings showed that the only factors that predicted the numbers of CFU-GM collected were prior treatment with the MOPP regimen and the number of mononuclear cells identified in the basophil channel of the H*1 = Technicon.

PBSC collection after high dose chemotherapy followed by G-CSF in patients with malignancies: analysis of results regarding factors affecting the yield of hemopoietic progenitors.

High-dose non ablative chemotherapy followed by growth factors efficiently mobilizes and amplifies Peripheral Blood stem Cells (PBSC). Cytofluorimetric PBSC monitoring reduces the number of leukapheresis needed to collect sufficient amounts of progenitors to restore hemopoiesis after myeloablative therapy. Twenty-eight patients, affected by lymphoproliferative disorders, were primed with non myeloablative chemotherapy followed by G-CSF 5 micrograms/kg/die subcutaneously, until leukapheresis.