Mobilization of hematopoietic stem cells in patients undergoing HSCT as a treatment of early diabetes type 1

Abstract

BackgroundThe immunoablation with autologous hematopoietic stem cell transplantation is a new experimental treatment of early diabetes type 1. The treatment is based on destruction of immune system with cytotoxic drugs which leads to halt of immune reaction directed against beta cells of pancreas. During that treatment young patients with diabetes type 1 who are otherwise healthy undergo mobilization with cyclophosphamide (CY) and G-CSF. They are naïve to cytotoxic drugs and mobilization is their first contact with chemotherapy. We analyzed the efficiency of mobilization with cyclophosphamide and G-CSF in this population. MethodsWe analyzed the medical records of 25 patients with diabetes who underwent mobilization with cyclophosphamide and G-CSF. ResultsThe median white blood cell count on the first day of apheresis was 14.6×103/μL (range 1.5–33.3) in CY+G-CSF mobilized patients. Median absolute CD 34+ cell count in peripheral blood on the first apheresis day was 0.095 127×103/μL (range 0.026–0.477). The median total number of collected CD34+ cells during one or two (if needed) aphereses was 466×106 (range 204–816) or 7.24×106 CD34+ cells per kg of patient body weight (range 3.03–13.1). There were no poor mobilizers who were unable to collect sufficient cell numbers. ConclusionThe mobilization of hematopoietic stem cells with CY+G-CSF in patients with early diabetes type 1 is efficient and the underlying diabetes does not impair the efficiency of hematopoietic stem cell collection.