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Appropriate timing of G‐CSF use after mobilization chemotherapy significantly increases the yield of CD34+ cells in autoPBSCT
Author(s) -
Xu Li,
Chang Chunkang,
Li Xiao,
Gan Weijin
Publication year - 2009
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.20219
Subject(s) - medicine , leukapheresis , etoposide , apheresis , vinblastine , urology , filgrastim , chemotherapy , autologous stem cell transplantation , granulocyte colony stimulating factor , transplantation , prednisone , gastroenterology , surgery , cd34 , stem cell , platelet , genetics , biology
The yield of CD34+ cells collected by apheresis for autologous peripheral blood stem cell (PBSC) transplantation was greatly increased when the appropriate timing was determined to begin using G‐CSF after COAEP (Cytoxan, Vinblastine, Arabinosylcytosin, Etoposide and Prednisone) mobilization. Twenty‐nine patients with lymphoma or multiple myeloma (MM) received the same mobilization chemotherapy, including cytoxan (CTX) 400 mg/m 2 d1; vinblastine (VLB) 2 mg/m 2 d1; Ara‐C 60 mg/m 2 × 5d; vp‐16 60 mg/m 2 × 5d; and prednisone 40 mg/m 2 × 5d. The historical control group (12 cases) received subcutaneous G‐CSF (filgrastim) at the first restoration after the initial nadir of the peripheral WBC count. The experimental group (17 cases) received G‐CSF during the steady rise of the WBC count (end of fluctuating after initial nadir). G‐CSF was given in a single daily subcutaneous dose of 5 μg/kg until the final PBSC apheresis. When the peripheral WBC and mononuclear cell (MNC) counts reached 10 × 10 9 /L and 1 × 10 9 /L, respectively, leukapheresis was carried out using the COBE Spectrablood cell separator. Despite comparable treatment with alkylating agents, a significantly increased yield of CD34‐positive cells was observed in the experimental group (32 × 10 6 /kg) compared with the historical control group (3.1 × 10 6 /kg) ( P = 0.0182). This result indicates the importance of appropriate timing for the use G‐CSF after mobilization chemotherapy to increase the CD34+ cell yield. J. Clin. Apheresis, 2009. © 2009 Wiley‐Liss, Inc.