Mobilizing peripheral blood stem cells with high-dose G-CSF alone is as effective as with Dexa-BEAM plus G-CSF in lymphoma patients.

Abstract

We compared retrospectively the efficacy of granulocyte colony stimulating factor (G-CSF) alone with chemotherapy plus G-CSF in mobilizing CD34-positive cells in patients with malignant lymphoma. 35 patients underwent peripheral blood stem cell (PBSC) collection following mobilization either with 24 microg/kg G-CSF for 4 consecutive days (n = 18) or Dexa-BEAM chemotherapy plus 5 microg/kg G-CSF (n = 17). High-dose G-CSF was well tolerated with only slight bone pain and/or myalgia. The Dexa-BEAM therapy required hospitalization with a median duration of 21 d. The median number of apheresis procedures in both groups was two (range two to four), resulting in a median of 5.3 and 5.1 x 10(6) CD34+ cells/kg. No patients in the G-CSF group, but one in the Dexa-BEAM group, failed to reach the target of collecting >2.0 x 10(6) CD34+ cells/kg. The number of CFU-GM (10.4 v 6.0 x 10(5)/kg) and of BFU-E (10.6 v 4.5 x 10(5)/kg; P = 0.04) was higher in the G-CSF group than in the Dexa-BEAM group. A subset analysis of CD34+ cells was performed in 16 patients showing a higher mean of Thy-1 (CD90w) coexpression in the G-CSF than in the Dexa-BEAM group (4.8 v 1.8%, P = 0.12). Additionally the percentage of CD34+/CD38- cells was higher in the G-CSF group (10.66% v 8.8%). However, these differences were not statistically significant. The median time to leucocyte and platelet engraftment after high-dose chemotherapy was slightly shorter in the G-CSF than in the Dexa-BEAM group (9 v 10 and 12 v 13.5 d, respectively). These results demonstrate that high-dose G-CSF is as effective as Dexa-BEAM plus G-CSF in mobilizing peripheral blood stem cells and produces prompt engraftment. The major advantages of G-CSF mobilization were the safe outpatient self-application and the fixed-day apheresis.

• Authors: N Kröger, W Zeller, N Fehse, H T Hassan, W Krüger, K Gutensohn, C Lölliger, A R Zander
• Journal: British journal of haematology (Br J Haematol) Vol. 102 Issue 4 Pg. 1101-6 (Sep 1998) ISSN: 0007-1048 [Print] England
• PMID: 9734664 (Publication Type: Journal Article)

Chemical References

• Antigens, CD34
• Recombinant Proteins
• Cytarabine
• Granulocyte Colony-Stimulating Factor
• Etoposide
• Dexamethasone
• Filgrastim
• Melphalan
• Carmustine

Topics

• Adolescent
• Adult
• Antigens, CD34 (analysis)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carmustine (administration & dosage, pharmacology)
• Colony-Forming Units Assay
• Cytarabine (administration & dosage, pharmacology)
• Dexamethasone (administration & dosage, pharmacology)
• Etoposide
• Female
• Filgrastim
• Graft Survival
• Granulocyte Colony-Stimulating Factor (adverse effects, therapeutic use)
• Hematopoietic Stem Cell Mobilization (methods)
• Hematopoietic Stem Cell Transplantation
• Hospitalization
• Humans
• Lymphoma (drug therapy)
• Male
• Melphalan (administration & dosage, pharmacology)
• Middle Aged
• Recombinant Proteins
• Retrospective Studies