Summary:there was more rapid recovery of platelets in patients receiving the higher CD34 + cell doses. 4 Some patients receiving Ͻ2-2.5 × 10 6 CD34 + cells/kg have greatly Engraftment kinetics after high-dose chemotherapy (HDC) were evaluated in patients receiving autologous delayed platelet recovery as compared to patients receiving a higher cell dose. 3,5-7 peripheral blood stem cell (PBSC) infusions with a low CD34 ؉ cell content. Forty-eight patients were infusedIt has also been suggested that there are factors other than CD34 + cell dose involved in hematologic recovery with Ͻ2.5 ؋ 10 6 CD34 ؉ cells/kg; 36 because of poor harvests and 12 because they electively received only a after HDC and PBSC infusion. For example, in a series of 225 patients with multiple myeloma receiving HDC, the fraction of their harvested cells. A median of 2.12 ؋ 10 6 CD34 ؉ cells/kg (range, 1.17-2.48) were infused followinfusion of 2.0 × 10 6 CD34 + cells/kg resulted in rapid engraftment in patients who had received Ͻ6 months of ing one of seven different HDC regimens. All patients achieved absolute neutrophil counts у 0.5 ؋ 10 9 /l at a therapy with melphalan, but Ͼ5 × 10 6 CD34 + cells/kg were required for rapid platelet recovery in patients who had median of day 11 (range, 9-16). Forty-seven patients achieved platelet counts у 20 ؋ 10 9 /l at a median of day received Ͼ12 months of melphalan. 8 Target CD34 + cell doses of 2.5 or 5.0 × 10 6 /kg are easily 14 (range, 8-250). Nine of 47 (19%) had platelet recovery after day 21, 4/47 (9%) after day 100 and one died achievable in the majority of patients. [3][4][5] In a relatively small fraction of heavily pretreated patients, however, these on day 240 without platelet recovery. Twenty-six patients (54%) died of progressive disease in 51-762 cell doses are not obtainable. 3-5 Furthermore, sequential or tandem administration of HDC followed by the infusion of days; 22 (46%) are alive at a median of 450 days (range, 94-1844), 17 (35%) of whom are surviving disease-free a fraction of harvested PBSC can result in the administration of relatively low CD34 + cell numbers after each at a median of 494 days (range, 55-1263). No patient died as a direct consequence of low blood cell counts.treatment. The purpose of this analysis was to evaluate the These data demonstrate that PBSC products containing 1.17-2.48 ؋ 10 6 CD34 ؉ cells/kg resulted in relatively engraftment kinetics in 48 patients with malignancy given HDC followed by PBSC containing Ͻ2.5 × 10 6 CD34 + prompt neutrophil recovery in all patients but approximately 10% had delayed platelet recovery. cells/kg. Keywords: engraftment; low CD34 ϩ cells Patients and methodsThe CD34 + cell content of peripheral blood stem cells Patient selection (PBSC) has been shown to be an accurate and proven predictor of engraftment kinetics, especially of platelets, folRecords were reviewed of 2079 nonleukemia patients lowing high-dose chemotherapy (HDC). 1-5 Infusion of treated with HDC and PBSC infusion between March 1991 PBSC containing у5 × 10 6 /k...

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We report the case of a 78-year-old man who developed a breast mass 12 months after hormonal therapy for palliation of prostatic adenocarcinoma. On histologic and immunohistochemical examination, the breast tumor revealed a unique collision tumor composed of metastatic prostatic adenocarcinoma and solid papillary breast carcinoma.