Mobilization of peripheral blood stem cells with chemotherapy and recombinant human granulocyte colony-stimulating factor (rhG-CSF): a randomized evaluation of different doses of rhG-CSF
| Autor: | Muhit Ozcan, Meltem Ayli, Osman Ilhan, Seher Demirer, Akin Uysal, Rauf Haznedar, Hamdi Akan, Nazan Günel, Taner Demirer, Turgay Fen, O. Arslan, Gunhan Gurman, Gülsüm Özet, M. Dagli, Suleyman Dincer, Haluk Koç, Yasemin Genç, Nahide Konuk |
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| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Chemotherapy Neutrophil Engraftment Platelet Engraftment business.industry medicine.medical_treatment Hematology Hematopoietic stem cell transplantation Gastroenterology Granulocyte colony-stimulating factor Surgery medicine.anatomical_structure Autologous stem-cell transplantation Internal medicine White blood cell medicine Stem cell business |
| Zdroj: | British Journal of Haematology. 116:468-474 |
| ISSN: | 0007-1048 |
| DOI: | 10.1046/j.1365-2141.2002.03264.x |
| Popis: | To date, no randomized study has compared different doses of recombinant human granulocyte colony-stimulating factor (rhG-CSF) following submyeloablative mobilization chemotherapy. Therefore, we evaluated the effect of different doses of rhG-CSF following mobilization chemotherapy on yields of CD34+ peripheral blood stem cells (PBSC). Fifty patients were randomized to receive 8 (n = 25) versus 16 microg/kg/d (n = 25) of rhG-CSF following mobilization chemotherapy. The median number of CD34+ cells collected after 8 microg/kg/d of rhG-CSF was 2.36 x 10(6)/kg (range, 0.21-7.80), compared with 7.99 (2.76-14.89) after 16 microg/kg/d (P < 0.001). Twenty out of 25 (80%) patients in the low-dose and 23 out of 25 (92%) in the high-dose rhG-CSF arm underwent high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT). Median days to white blood cell engraftment in patients mobilized with 8 microg/kg and 16 microg/kg of rhG-CSF were 12 (10-20) and 9 (8-11) respectively (P < 0.001). There was no difference between the two groups regarding the other parameters of peritransplant morbidity: days to platelet engraftment (P = 0.10), number of red blood cell (P = 0.56) and platelet transfusions (P = 0.22), days of total parenteral nutrition requirement (P = 0.84), fever (P = 0.93) and antibiotics (P = 0.77), and number of different antibiotics used (P = 0.58). These data showed that higher doses of rhG-CSF following submyeloablative mobilization chemotherapy were associated with a clear dose-response effect based on the collected cell yields. Based on the parameters of peritransplant morbidity, 8 microg/kg/d was as effective as 16 microg/kg/d except for a rapid neutrophil engraftment in the high-dose arm. Therefore, in routine clinical practice, despite some advantage in the use of higher doses of rhG-CSF, lower doses may be used for PBSC collections following chemotherapy-based mobilization regimens in this cost-conscious era. |
| Databáze: | OpenAIRE |
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