Peripheral Stem Cell Apheresis is Feasible Post 131Iodine-Metaiodobenzylguanidine-Therapy in High-Risk Neuroblastoma, but Results in Delayed Platelet Reconstitution

Abstract

Purpose: Targeted radiotherapy with 131 iodine-metaiodobenzylguanidine ( 131 I-MIBG) is effective for neuroblastoma (NBL), although optimal scheduling during high-risk (HR) treatment is being investigated. We aimed to evaluate the feasibility of stem cell apheresis and study hematologic reconstitution after autologous stem cell transplantation (ASCT) in patients with HR-NBL treated with upfront 131 I-MIBG-therapy.Experimental Design: In two prospective multicenter cohort studies, newly diagnosed patients with HR-NBL were treated with two courses of 131 I-MIBG-therapy, followed by an HR-induction protocol. Hematopoietic stem and progenitor cell (e.g., CD34 þ cell) harvest yield, required number of apheresis sessions, and time to neutrophil (>0.5 Â 10 9 /L) and platelet (>20 Â 10 9 /L) reconstitution after ASCT were analyzed and compared with "chemotherapy-only"-treated patients. Moreover, harvested CD34 þ cells were functionally (viability and clonogenic capacity) and phenotypically (CD33, CD41, and CD62L) tested before cryopreservation (n ¼ 44) and/or after thawing (n ¼ 19).Results: Thirty-eight patients (47%) were treated with 131

Detection of Circulating Tumor Cells in the Diagnostic Leukapheresis Product of Non-Small-Cell Lung Cancer Patients Comparing CellSearch® and ISET

“…With DLA, sufficient CTCs could be isolated to allow for diagnostic tests and tumor typing to be performed. As shown in our study and others, complications associated with DLA are mild and rare, making it an easily tolerable procedure even for NSCLC patients [39][40][41][42] The number of included patients in our study was relatively small and heterogeneous in stage and treatment line. However, previous studies have shown that the number of CTCs is not influenced by these patient characteristics, and any influence of patient characteristics is accounted for since the comparisons were performed for each patient in a matched manner.…”

“…CTC detection has been increased by DLA in prostate and breast cancer patients before, but only small volumes of DLA product were processed [9][10][11]38]. DLA is a well-tolerable procedure, even in our NSCLC population, and has few complications, while placing minimal burden (only two hours of time) on patients [39][40][41][42]. Also the calculated efficacy of our procedures in isolating mononuclear cells (MNCs) was shown to be comparable with that of isolating stem cells, and DLAs in breast cancer patients [8][9][10][11]43].…”

Leukapheresis increases circulating tumour cell yield in non-small cell lung cancer, counts related to tumour response and survival

“…origin [27]. Apheresis is known to be a tolerable procedure [28][29][30][31][32]. Recently, DLA was shown to increase CTC detection in prostate and breast cancer, even when patients had early-stage disease [10][11][12]27].…”

Thrombocytopenia after meta-iodobenzylguanidine (MIBG) therapy in neuroblastoma patients may be caused by selective MIBG uptake via the serotonin transporter located on megakaryocytes

“…Our finding that megakaryocytes are capable of selective MIBG uptake may explain these findings. Our group described earlier that peripheral blood stem cell (PBSC) apheresis is feasible after upfront 131 I-MIBG therapy in neuroblastoma patients, although delayed platelet reconstitution occurred after reinfusion in MIBG-treated patients in comparison with chemotherapy-only-treated patients [ 42 ]. Interestingly, no association was found between bone marrow tumor infiltration at diagnosis and platelet reconstitution.…”