Progenitor cell yield in sequential blood stem cell mobilization in the same patients: insights into chemotherapy dose escalation and combination of haemopoietic growth factor and chemotherapy

Abstract

Between April 1988 and March 1994 a total of 23 patients with haematological or non-haematological malignancies received serial peripheral blood stem cell (PBSC) mobilization to attain sufficient harvest for PBSC transplant at our institution. There was no improvement in yield with the second mobilization for group A patients (n = 12) who had the same dose of cyclophosphamide twice as mobilizing agent. For group B patients (n = 6). who had a higher dose of cyclophosphamide with the second mobilization, there was significant increase in CFU-GM yield. CD34+ cell yield was not measured. For group C patients, who received interleukin-3 plus granulocyte-macrophage colony-stimulating factor (GM-CSF) with the first mobilization and chemotherapy plus GM-CSF with the second, there was significant increase in CFU-GM as well as CD34+ cell yield. Our results demonstrate that, at the doses studied, chemotherapy dose escalation and combining haemopoietic growth factor with chemotherapy improve progenitor cell yield in PBSC mobilization.