Abstract
We investigated the efficiency of mitoxantrone (MIT) and high-dose cytarabine (Ara-C) chemotherapy followed by G-CSF and G-CSF/GM-CSF treatments for the mobilization of peripheral blood stem cells (PBSCs) in patients with leukemia and lymphoma. MIT was intravenously injected at 10 mg/(m2·d) for 2 to 3 days, followed by Ara-C injected intravenously at 2 g/m2 every 12 hours for 1 to 2 days. When white blood cell count recovered from the lowest value, 5 to 7.5 μg/ (kg·d) G-CSF was administered in 23 patients for 5 to 7 successive days. Another 27 patients received 3-5 μg/ (kg·d) G-CSF and 3-5μg/ (kg·d) GM-CSF. Autologous peripheral blood mononuclear cells were collected. Levels of CFU-GM and CD34+ cells were determined after unfreezing. The CD34+ cells and CFU-GM yields of 27 patients in G-CSF plus GM-CSF combination group [(8.79±3.11)×106/kg, (3.52±1.34)×105/kg, respectively] were significantly higher than those of patients receiving G-CSF alone (n=23) [(6.14±2.06)×106/kg, (2.03±1.06)×105/kg, respectively (P < 0.05)]. No obvious changes of T lymphocyte subsets in patients were observed when using G-CSF/GM-CSF, but levels of CD34+ cells increased gradually (P>0.05). The end-point separation blood volume was all above trebling TBV. No severe complications were observed during the mobilization and collection. Autologous PBSCT obtained quick hematopoietic reconstitution. In conclusion, MA chemotherapy combined with G-CSF alone and G-CSF/GM-CSF can safely and effectively mobilize autologous PBSCs, while G-CSF plus GM-CSF is superior to G-CSF alone. Large volume leukapheresis is an important method to enhance the production rate of stem cells and decrease harvesting time.
Highlights
In the present decade, peripheral blood stem and progenitor cells have been widely used as a source of hematopoietic stem cells as they provide rapid and sustained hematologic reconstitution following autologous and allogeneic grafts
We investigated the efficiency of mitoxantrone (MIT) and high-dose cytarabine (Ara-C) chemotherapy followed by granulocyte colony-stimulating factor (G-CSF) and G-CSF/granulocytemacrophage colony-stimulating factor (GM-CSF) treatments for the mobilization of peripheral blood stem cells (PBSCs) in patients with leukemia and lymphoma
Autologous peripheral blood stem cell transplantation (PBSCT) for leukemia and lymphoma offers higher response rates and improved survival compared with conventional chemotherapy
Summary
Peripheral blood stem and progenitor cells have been widely used as a source of hematopoietic stem cells as they provide rapid and sustained hematologic reconstitution following autologous and allogeneic grafts. Successful autografting requires effective mobilization and rapid hematologic reconstitution [1, 2]. Peripheral blood stem cells (PBSCs) mobilization occurs by administering granulocyte colony-stimulating factor (G-CSF) and granulocytemacrophage colony-stimulating factor (GM-CSF) alone or in combination with chemotherapy. Both cytokines differ in the number and composition of PBSCs and effector cells mobilized to the peripheral blood. Previous studies have shown a correlation between clinical outcome and graft composition [3,4,5]. It is generally recognized that GCSF as a single agent mobilizes more CD34+ cells than does GM-CSF
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