Effect of peripheral-blood progenitor cells mobilised by filgrastim (G-CSF) on platelet recovery after high-dose chemotherapy

Autor:	W.P. Sheridan, R.M. Fox, C.G. Begley, D. Maher, K.M. McGrath, C.A. Juttner, L.Bik To, J. Szer, G. Mostyn
Rok vydání:	1992
Předmět:	Adult Blood Platelets Male medicine.medical_specialty Time Factors Adolescent Cyclophosphamide medicine.medical_treatment Antineoplastic Agents Hematopoietic stem cell transplantation Filgrastim Pharmacology Granulocyte Granulopoiesis Leukocyte Count Internal medicine Granulocyte Colony-Stimulating Factor medicine Humans Progenitor cell Bone Marrow Transplantation Erythroid Precursor Cells Chemotherapy business.industry Hematopoietic Stem Cell Transplantation General Medicine Middle Aged Hematopoietic Stem Cells Recombinant Proteins Granulocyte colony-stimulating factor Endocrinology medicine.anatomical_structure Female business medicine.drug
Zdroj:	The Lancet. 339:640-644
ISSN:	0140-6736
DOI:	10.1016/0140-6736(92)90795-5
Popis:	The haemopoietic growth factor granulocyte colony-stimulating factor (G-CSF; filgrastim) substantially shortens the period of severe neutropenia that follows high-dose chemotherapy and autologous bone-marrow infusion by stimulating granulopoiesis. Filgrastim also increases numbers of circulating progenitor cells. We have studied the ability of filgrastim to mobilise peripheral-blood progenitor cells and assessed their efficacy when infused after chemotherapy on recovery of neutrophil and platelet counts. 17 patients with non-myeloid malignant disorders received filgrastim (12 micrograms/kg daily for 6 days) by continuous subcutaneous infusion. Numbers of granulocyte-macrophage progenitors in peripheral blood increased a median of 58-fold over pretreatment values, and numbers of erythroid progenitors increased a median of 24-fold. Three leucapheresis procedures collected a mean total of 33 (SEM 5.7) x 10(4) granulocyte-macrophage progenitors per kg body weight. After high-dose chemotherapy in 14 of the patients (busulphan and cyclophosphamide), these cells were used to augment autologous bone-marrow rescue and post-transplant filgrastim treatment. Platelet recovery was significantly faster in these patients than in controls who received the same treatment apart from the infusion of peripheral-blood progenitors; the platelet count reached 50 x 10(9)/l a median of 15 days after infusion of haemopoietic cells in the study patients compared with 39 days in controls (p = 0.0006). The accelerated neutrophil recovery associated with filgrastim treatment after chemotherapy was maintained. This method may be widely applicable to aid both neutrophil and platelet recovery after high-dose chemotherapy; it will allow investigation of peripheral-blood progenitor-cell allotransplantation.
Databáze:	OpenAIRE
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