Impact of chemotherapy regimen and hematopoietic growth factor on mobilization and collection of peripheral blood stem cells in cancer patients

Nowrousian, Mohammad R.; Waschke, S R; Bojko, Peter; Welt, Anja; Schuett, P.; Ebeling, Peter R.; Flaßhove, Michael; Möritz, Thomas; Schuette, Jochen; Seeber, S.

doi:10.1093/annonc/mdg706

Cited by 35 publications

(31 citation statements)

References 54 publications

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“…The COAEP protocol resulted in acceptable CD341 cells yields in the present study. Treatment with G-CSF usually begins 24-72 h after the completion of mobilizing chemotherapy [4,6]. In previous reports, CD341 cell yields reached 6.7-6.8 3 10 6 /kg body weight [4,6], with a mean of 12-15 days of G-CSF treatment and a mean of 2-5.24 sessions of leukapheresis.…”

Section: Discussionmentioning

confidence: 96%

“…In this case, the median duration of G-CSF use is 12-15 days before the first apheresis [4,6]. Other centers start using G-CSF at the time of initial WBC or platelet recovery following mobilization [7].…”

Section: Introductionmentioning

confidence: 98%

“…Mobilization is an important component of this treatment procedure and is achieved with growth factors in almost all cases, with or without combination with chemotherapy [3,4]. Although a minimally sufficient number of CD341 cells to allow successful engraftment can be obtained from the majority of patients using current techniques [5], a greater number of stem cells is beneficial for recipients to achieve more rapid engraftment.…”

Section: Introductionmentioning

confidence: 99%

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Appropriate timing of G‐CSF use after mobilization chemotherapy significantly increases the yield of CD34+ cells in autoPBSCT

Xu¹,

Chang²,

Li³

et al. 2009

J of Clinical Apheresis

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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) x 5d; vp-16 60 mg/m(2) x 5d; and prednisone 40 mg/m(2) x 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 microg/kg until the final PBSC apheresis. When the peripheral WBC and mononuclear cell (MNC) counts reached 10 x 10(9)/L and 1 x 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 x 10(6)/kg) compared with the historical control group (3.1 x 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.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Appropriate timing of G‐CSF use after mobilization chemotherapy significantly increases the yield of CD34+ cells in autoPBSCT

Xu¹,

Chang²,

Li³

et al. 2009

J of Clinical Apheresis

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“…However, this correlation was not significant in multivariate analysis except for PB CD34+ cell concentration (11) . A high predictive value of PB CD34+ cell concentration and the yield of these cells in the apheresis product have been reported (11,26) . The limitations of this retrospective study include sample heterogeneity, disease status and different mobilization regimens.…”

Section: Discussionmentioning

confidence: 98%

Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience

Sakashita

Kondo

Ribeiro

et al. 2011

Einstein (São Paulo)

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Objective: To evaluate factors affecting peripheral blood hematopoietic stem cell yield in patients undergoing large-volume leukapheresis for autologous peripheral blood stem cell collection. Methods: Data from 304 consecutive autologous peripheral blood stem cell donors mobilized with hematopoietic growth factor (usually G-CSF), associated or not with chemotherapy, at Hospital Israelita Albert Einstein between February 1999 and June 2010 were retrospectively analyzed. The objective was to obtain at least 2 × 106 CD34+ cells/kg of body weight. Pre-mobilization factors analyzed included patient's age, gender and diagnosis. Post mobilization parameters evaluated were pre-apheresis peripheral white blood cell count, immature circulating cell count, mononuclear cell count, peripheral blood CD34+ cell count, platelet count, and hemoglobin level. The effect of pre and post-mobilization factors on hematopoietic stem cell collection yield was investigated using logistic regression analysis (univariate and multivariate approaches). Results: Pre-mobilization factors correlating to poor CD34 + cell yield in univariate analysis were acute myeloid leukemia (p = 0.017) and other hematological diseases (p = 0.023). Significant post-mobilization factors included peripheral blood immature circulating cells (p = 0.001), granulocytes (p = 0.002), hemoglobin level (p = 0.016), and CD34+ cell concentration (p < 0.001) in the first harvesting day. However, according to multivariate analysis, peripheral blood CD34+ cell content (p < 0.001) was the only independent factor that significantly correlated to poor hematopoietic stem cell yield. Conclusion: In this study, peripheral blood CD34+ cell concentration was the only factor significantly correlated to yield in patients submitted to for autologous collection.

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“…[23][24][25][26] During the time period of our study, 28 patients (unpublished data) received disease-specific chemotherapy primes with G-CSF and the median time to first harvest was 13 days (range [11][12][13][14][15][16][17][18]. Stem cell recovery is more rapid however following low-dose cyclophosphamide/G-CSF.…”

Section: Discussionmentioning

confidence: 99%

An analysis of the optimal timing of peripheral blood stem cell harvesting following priming with cyclophosphamide and G-CSF

Hill

Buxton

Pearce³

et al. 2007

Bone Marrow Transplant

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Increasing demand on the apheresis service makes efficient harvesting of peripheral blood stem cells (PBSCs) essential. A total of 168 adult patients with haematological malignancy were primed using low-moderate dose cyclophosphamide (1.5-3 g/m 2 ) with G-CSF 5-10 lg/kg per day. Harvesting was booked and peripheral blood (PB) counts first checked between 6 and 10 days postpriming. One hundred and thirty (77%) patients harvested successfully (total harvest yield X2 Â 10 6 CD34 þ /kg) and the median PBSC collection per procedure was 2.18 Â 10 6 /kg (range 0.1-14.5). Only more lines of prior chemotherapy predicted failure to harvest in multivariate analysis (P ¼ 0.003). The PB CD34 þ cell count correlated significantly with harvest yield (r ¼ 0.8448, Po0.0001). A PB CD34 þ count X10/ll predicted a collection of X2 Â 10 6 /kg (positive-predictive value of 61%, negative-predictive-value 100%). Patients first attending day 9 required significantly fewer visits to achieve a successful harvest than those first attending days 6-8 without increasing the risk of failure. No significant difference in failure rates, number of days attending and total harvest yield was found between days 9 and 10 attendees. Collection from day 9 may however enable higher target yields to be achieved. PB CD34 þ count monitoring should commence and harvesting booked from day 9 to optimize both the harvest and the efficiency of the PBSC harvesting service.

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Impact of chemotherapy regimen and hematopoietic growth factor on mobilization and collection of peripheral blood stem cells in cancer patients

Cited by 35 publications

References 54 publications

Appropriate timing of G‐CSF use after mobilization chemotherapy significantly increases the yield of CD34+ cells in autoPBSCT

Appropriate timing of G‐CSF use after mobilization chemotherapy significantly increases the yield of CD34+ cells in autoPBSCT

Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience

An analysis of the optimal timing of peripheral blood stem cell harvesting following priming with cyclophosphamide and G-CSF

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