Abstract |
To increase the stem cell content of T cell-depleted bone marrow transplants (BMT), we treated 12 patients with hematological malignancies with BMT from HLA-identical sibling donors given G-CSF 10 microg/kg/day for 5 days before marrow harvest. After CD34+ cell selection, patients received a median of 1.7 (range, 0.82-3.1) x 10(6) CD34+ cells/kg and 2.3 (range, 0.25-4.0) x 10(5) CD3+ cells/kg. All patients had initial engraftment but four developed pancytopenia between days 55-130 post-BMT. In two patients, this required a second infusion of G-CSF-mobilized donor peripheral blood progenitor cells. We observed no delayed pancytopenia in a matched historical group of 24 patients receiving T cell-depleted BMT without prior G-CSF stimulation. Compared to this control group, G-CSF-stimulated marrow recipients showed a significant decline in neutrophil and monocyte counts after 8 weeks. However, outcome after BMT was otherwise comparable, with a similar incidence of acute graft-versus-host disease and transplant-related mortality. Disease-free survival was 63 vs 67% for controls matched for CD34+ cell dose (P = NS). These results indicate that G-CSF stimulation can increase the CD34+ cell content of T cell-depleted marrow but carries a risk of late graft failure.
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Authors | D A Mavroudis, E J Read, J Molldrem, A Raptis, M Plante, C S Carter, S Phang, C E Dunbar, A J Barrett |
Journal | Bone marrow transplantation
(Bone Marrow Transplant)
Vol. 21
Issue 5
Pg. 431-40
(Mar 1998)
ISSN: 0268-3369 [Print] England |
PMID | 9535034
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Antigens, CD34
- Granulocyte Colony-Stimulating Factor
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Topics |
- Adolescent
- Adult
- Antigens, CD34
- Bone Marrow Transplantation
(adverse effects, methods)
- Cytomegalovirus
(growth & development)
- Disease-Free Survival
- Erythrocyte Transfusion
- Female
- Granulocyte Colony-Stimulating Factor
(therapeutic use)
- Hematologic Neoplasms
(therapy)
- Hematopoietic Stem Cells
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
(therapy)
- Leukocyte Count
- Male
- Middle Aged
- Myelodysplastic Syndromes
(therapy)
- Pancytopenia
(etiology)
- Platelet Transfusion
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(therapy)
- T-Lymphocytes
- Transplantation Conditioning
- Virus Activation
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