Autologous peripheral hematopoietic stem cell transplantation restores hematopoietic function following marrow ablative therapy

Abstract

From ten patients with advanced malignant disease involving the bone marrow, autologous hematopoietic stem cells were collected from the peripheral blood during eight four-hour pheresis procedures and cryopreserved. No manipulations to increase the number of stem cells circulating in the blood were used during the collections. Following marrow ablative chemotherapy or chemoradiotherapy, the autologous cells were thawed and infused intravenously (IV). WBCs reappeared in the circulation at a median of eight days (range seven to 11 days) after stem cell infusion. Two patients died early, whereas the other eight reached normal numbers of circulating granulocytes that have persisted for up to greater than 20 months. These eight patients became independent of RBC transfusions (hemoglobin concentration greater than 10 g/dL) at a median of 27 days (range 11 to 58 days) after transplantation. One patient received platelet transfusions for counts less than 50 x 109)/L, one patient developed a clinical picture of idiopathic thrombocytopenic purpura, and six patients maintained a platelet count greater than 20 x 10(9)/L at a median of 23 days (range 14 to 25 days) following stem cell infusion. This technique allows patients ineligible for autologous bone marrow transplantation due to unacceptable anesthetic risks, prior pelvic irradiation, or bone marrow metastases to receive marrow ablative therapy.

A cell‐kinetic model of CD34+ cell mobilization and harvest: development of a predictive algorithm for CD34+ cell yield in PBPC collections

“…Collection of PBPCs can be performed without general anesthesia, engraftment is faster, and supportive care and costs are reduced. PBPCs are harvested by leukapheresis after mobilization with chemotherapy and/or G–CSF or GM–CSF alone 1–5 …”

A prospective, randomized, sequential, crossover trial of large‐volume versus normal‐volume leukapheresis procedures: effect on progenitor cells and engraftment

“…Collection of PBPCs can be performed without general anesthesia, engraftment is faster, and supportive care and costs are reduced. PBPCs are harvested by leukapheresis after mobilization with chemotherapy and/or granulocyte–colony‐stimulating factor (G–CSF) or granulocyte‐macrophage–CSF (GM–CSF) 1–5 …”

The timing of granulocyte–colony‐stimulating factor administration after chemotherapy does not affect stem and progenitor cell apheresis yield: a retrospective study of 65 cases

“…Autologous peripheral blood stem and progenitor cells (PBPCs) are increasingly used for hemato‐ poietic cell grafting after high‐dose chemother‐ apy for malignant disease 1,2 . Mobilization techniques include the administration of hematopoietic growth factors after chemotherapy 3 .…”