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Mobilization and harvesting of peripheral blood stem cells: randomized evaluations of different doses of filgrastim
Author(s) -
Weaver C. H.,
Birch R.,
Greco F. A.,
Schwartzberg L.,
McAneny B.,
Moore M.,
Oviatt D.,
Redmond J.,
George C.,
Alberico T.,
Johnson P.,
Buckner C. D.
Publication year - 1998
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1998.00573.x
Subject(s) - filgrastim , apheresis , cd34 , medicine , urology , randomized controlled trial , chemotherapy , gastroenterology , granulocyte colony stimulating factor , stem cell , surgery , biology , platelet , genetics
The effects of different doses of filgrastim on yields of CD34 + peripheral blood stem cells were evaluated in patients with breast cancer. 55 were randomized to receive filgrastim 10, 20, 30 or 40 μg/kg/d with more CD34 + cells/kg/apheresis harvested after the three highest dose levels. 35 additional patients were randomized to receive 10 or 30 μg/kg. The median number of CD34 + cells collected after 10 μg/kg ( n = 31) was 0.7 × 10 6 /kg/apheresis (range 0.1–4.4) as compared to 1.2 (range 0.1–6.8) after 30 μg/kg ( n = 32) ( P = 0.04). Among patients randomized to 10 v 30 μg/kg, more (50%) achieved 5.0 × 10 6 CD34 + cells/kg and less aphereses were required to achieve 2.5 × 10 6 CD34 + cells/kg after the higher dose ( P = 0.04). In multivariate analyses, patients receiving 10 μg/kg ( n = 31) had lower yields of CD34 + cells ( P = 0.026) and had a 3.3‐fold increase in the probability of not achieving 5.0 × 10 6 CD34 + cells/kg as compared to patients receiving 20–40 μg/kg ( n = 59). Patients who had received radiation had a 2.9‐fold probability of not achieving 2.5 × 10 6 CD34 + cells/kg. These data suggest that, in patients with good marrow reserves, doses of filgrastim > 10 μg/kg/d mobilized more CD34 + cells and may be useful when high numbers of CD34 + cells are desired.