scholarly journals Contamination of peripheral blood stem cell harvests by circulating neuroblastoma cells

Blood ◽  
1990 ◽  
Vol 76 (9) ◽  
pp. 1879-1883
Author(s):  
TJ Moss ◽  
DG Sanders ◽  
LC Lasky ◽  
B Bostrom
Keyword(s):  
Induction Chemotherapy ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Neuroblastoma Cells ◽  
Peripheral Blood Stem Cells ◽  
Solid Malignancies ◽  
Blood Stem Cells ◽  
Substantial Risk ◽  
Blood Specimens ◽  
Circulating Neoplastic Cells

Peripheral blood stem cells (PBSC) are being used as one alternative to autologous marrow rescue for patients with neuroblastoma and other solid malignancies. Some physicians prefer use of PBSC because less risk of tumor contamination is believed to exist. This hypothesis was evaluated by immunocytologic analysis of blood samples and concurrently drawn bone marrow (BM) samples and of PBSC harvests obtained from 31 patients with disseminated neuroblastoma. We found circulating neoplastic cells in 75% of specimens analyzed at diagnosis, in 36% during therapy, and in 14% of PBSC harvests. Tumor cells in blood obtained during therapy did not appear until 3 months after the time of diagnosis. Clearance of circulating neuroblastoma cells was documented after two courses of induction chemotherapy. Six of 13 patients with minimal or no BM disease had positive blood specimens. We conclude that substantial risk of tumor contamination of PB harvests exists and recommend that induction chemotherapy be administered before hematopoietic progenitor cells are collected from blood.

scholarly journals Contamination of peripheral blood stem cell harvests by circulating neuroblastoma cells

Blood ◽  
1990 ◽  
Vol 76 (9) ◽  
pp. 1879-1883 ◽  
Author(s):  
TJ Moss ◽  
DG Sanders ◽  
LC Lasky ◽  
B Bostrom
Keyword(s):  
Induction Chemotherapy ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Neuroblastoma Cells ◽  
Peripheral Blood Stem Cells ◽  
Solid Malignancies ◽  
Blood Stem Cells ◽  
Substantial Risk ◽  
Blood Specimens ◽  
Circulating Neoplastic Cells

Abstract Peripheral blood stem cells (PBSC) are being used as one alternative to autologous marrow rescue for patients with neuroblastoma and other solid malignancies. Some physicians prefer use of PBSC because less risk of tumor contamination is believed to exist. This hypothesis was evaluated by immunocytologic analysis of blood samples and concurrently drawn bone marrow (BM) samples and of PBSC harvests obtained from 31 patients with disseminated neuroblastoma. We found circulating neoplastic cells in 75% of specimens analyzed at diagnosis, in 36% during therapy, and in 14% of PBSC harvests. Tumor cells in blood obtained during therapy did not appear until 3 months after the time of diagnosis. Clearance of circulating neuroblastoma cells was documented after two courses of induction chemotherapy. Six of 13 patients with minimal or no BM disease had positive blood specimens. We conclude that substantial risk of tumor contamination of PB harvests exists and recommend that induction chemotherapy be administered before hematopoietic progenitor cells are collected from blood.

RICE/ICE Is an Effective PBSC Mobilising Regime in Patients with Aggressive Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5513-5513
Author(s):  
Edward Wilson ◽  
Rachel Pawson ◽  
Kathleen Beston ◽  
John Smyth ◽  
Chris Hatton
Keyword(s):  
Stem Cell ◽  
Induction Chemotherapy ◽  
Peripheral Blood ◽  
Large Cell ◽  
Aggressive Lymphoma ◽  
Low Grade ◽  
Peripheral Blood Stem Cells ◽  
Peripheral Blood Cd34 ◽  
Number Of Patients ◽  
Blood Stem Cells

Abstract RICE/ICE is an effective re-induction chemotherapy regime for patients with relapsed or refractory aggressive lymphoma prior to autologous stem cell transplantation. There is however a paucity of data on its effectiveness as a peripheral blood stem cell mobilising regime. We present data on its use in 23 patients, age 50 ± 15 (mean ± SD), with relapsed (n=16) or primary refactory (n=7) lymphoma (DLBCL (n=15), mantle cell (n=1), high grade transformation of follicular lymphoma (n=5), Hodgkins lymphoma (n=1), Anaplastic large cell lymphoma (n=1)). RICE (Rituximab 375mg/m2 (day 1), Etoposide 100mg/m2 (days 1–3), Carboplatin 5x(CrCl+25)mg/m2 (day 2) and Ifosphamide 5000mg/m2 (day 2)) was administered as re-induction chemotherapy (4 patients did not receive Rituximab) along with Filgrastim 10mcg/kg/day from day 5 until collection. Apheresis was attempted on day 15 in those patients (n=18) achieving a peripheral blood CD34+ve cell count greater than 10x103/ml. Peripheral blood stem cells were collected on a Gambro Cobe Spectra cell seperator processing a median of 2.5 blood volumes by standard protocols. Eight patients achieved a successful collection in the first apheresis session, six patients required a single further collection on day 16 and four patients required further collections on days 16 and 17. The median CD34+ve cell dose collected was 5.01x106/kg (range 0.5x106/kg − 17.4x106/kg) with only 2 patients achieving inadequate collections (0.5x106/kg and 1.37x106/kg). In total 70% (16 of 23) of patients successfully achieved PBSC collections of greater than 2.0x106/kg. The group of patients that failed to mobilise was not predictable in terms of known adverse markers such as marrow involvement, underlying low grade lymphoma or previous chemo/radiotherapy. In conclusion successful PBSC collection was achieved in the majority of patients treated with RICE/ICE although the number of patients is small and larger numbers will be required to confirm these results.

scholarly journals α4 integrin levels on mobilized peripheral blood stem cells predict rapidity of engraftment in patients receiving autologous stem cell transplantation

Blood ◽  
2011 ◽  
Vol 118 (8) ◽  
pp. 2362-2365 ◽  
Author(s):  
Bernd Hartz ◽  
Thorsten Volkmann ◽  
Sebastian Irle ◽  
Cordula Loechelt ◽  
Andreas Neubauer ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Peripheral Blood Stem Cells ◽  
Expression Levels ◽  
Blood Stem Cells ◽  
Mobilized Peripheral Blood

Abstract Rapidness of leukocyte engraftment in patients receiving peripheral blood stem cell transplantation is clinically important because the risk of fatal opportunistic infections increases with time to engraftment. Adhesion receptor molecules on hematopoietic stem cells (HSCs) have been shown to modulate homing and engraftment of HSCs. Therefore, we correlated expression levels of α4 (CD49d) and α6 (CD49f) integrins in the CD34+ HSC compartment with time to engraftment. Leukapheresis products from 103 patients were retrospectively analyzed for CD34, CD38, CD3, CD49f, and CD49d surface molecules by multiparameter flow cytometry. High expression levels of α4 integrin, but not α6 integrin on CD34+ cells, were associated with regular engraftment of leukocytes (days 8-19), whereas low surface expression correlated with delayed recovery (> 19 days; P < .0005). We show that α4 integrin expression levels on HSCs in leukapheresis products predict the engraftment capacity of mobilized peripheral blood stem cells in peripheral blood stem cell transplantation patients.

Peripheral Blood Stem-Cell Mobilisation and Autologous Stem Cell Transplantation In HIV-Related Malignancies.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4592-4592
Author(s):  
Marcus Hentrich ◽  
Xaver Schiel ◽  
Fuat Oduncu ◽  
Arthur Gerl ◽  
Clemens Scheidegger ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
High Dose ◽  
Peripheral Blood Stem Cells ◽  
Hiv Rna ◽  
Cd34 Cells ◽  
Blood Stem Cells ◽  
Neutrophil Engraftment

Abstract Abstract 4592 Introduction: Patients (pts) with HIV-infection are generally excluded from clinical trials that evaluate the role of high dose chemotherapy (HDCT) in malignant lymphoma or relapsed germ cell tumor (GCT). However, recent data indicate that HDCT followed by autologous peripheral blood stem cell transplantation (ASCT) may be effective in relapsed HIV-related lymphoma. Methods: This is an observational cohort study including patients with HIV-related lymphoma or HIV-related GCT who have peripheral blood stem cells mobilized by a combination of chemotherapy (CT) and G-CSF. Pts did or did not undergo consecutive ASCT. The primary outcome measure is feasibility. High-dose BEAM was used as a conditioning regimen in pts with HIV-related lymphoma while high-dose carboplatin/etoposide (CE) was chosen for pts with GCT. Results: From 07/05 to 03/10 peripheral blood stem cells (PBSC) were successfully harvested in 10 of 11 HIV-infected pts with diffuse large B-cell lymphoma (DLBCL) [n=4], Burkitt's lymphoma (BL) [n=3], plasmablastic lymphoma (PL) [n=2], Hodgkin lymphoma (HL) [n=1] and testicular GCT [n=1]. The mean number of collected stem cells was 15.7×106/kg CD34+ cells (range, 6.3 – 33). PBSC-mobilisation failed in one pt with relapsed BL. 7 of 11 pts were mobilized following salvage CT for DLBCL [n=4], BL [n=1], HL [n=1] or GCT [n=1] while 4 pts were under primary CT for BL or PL. So far, 5 of 10 pts received HDCT + ASCT. Pt 1 (44 yrs, CDC C3; HIV-RNA< 50 cop/ml at time of SCT) received HDCT as 3rd salvage therapy for DLBCL. A total of 9.2 × 106/kg CD34+ cells were transplanted. Neutrophil engraftment occurred on day +14. The pt achieved a partial remission but died of progressive lymphoma 6 months after ASCT. Pt 2 (60 yrs, CDC B3; HIV-RNA< 50/ml) underwent HDCT + ASCT (13.8 × 106/kg CD34+ cells) for a 1st relapse of HL. Neutrophil engraftment was observed on day +10. The pt is well and disease free 25 months after ASCT. Pt 3 (26 yrs, CDC C3, HIV-RNA< 50/ml), a hepatitis C co-infected haemophiliac, received HDCT + ASCT for refractory DLBCL but died of liver cirrhosis and neutropenic sepsis with multi-organ failure on day +16. Pt 4 (25 yrs, CDC A3, HIV-RNA< 50/ml) received 3 sequential courses of HD-CE followed by ASCT in 3-week intervals for a 3rd relapse of a nonseminomatous GCT. Neutrophil engraftment occurred on day +10, + 12 and +14, respectively. A complete remission (CR) was achieved. However, the pt suffered another relapse involving the central nervous system and died of progressive GCT 15 month after the 3rd transplant. Pt 5 (41 yrs, CDC C3, HIV-RNA 220/ml) underwent HDCT in 2nd complete remission after successful salvage-CT for a first sensitive relapse of DLBCL. A total of 12.9 × 106/kg CD34+ cells were transplanted. The pt is currently alive and neutropenic (day +3). ASCT was not performed in the other 6 pts because of refractory BL [n=1], ongoing first remission following induction CT for BL [n=2] and PL [n=2] and concomitant histoplasmosis necessitating antifungal therapy [n=1]. Conclusions: Successful mobilisation of PBSC is feasible in the majority of pts with HIV-related malignancies. ASCT seems effective in selected pts with chemo-sensitive relapse of malignant lymphoma or GCT. HIV-infected pts should no longer be excluded from HDCT-programs. Disclosures: No relevant conflicts of interest to declare.

Cryopreserved Allogeneic Peripheral Blood Stem Cells Result in Outcome Equivalent to Those of Fresh Infusions Enabling Rational Scheduling of Donations,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4052-4052
Author(s):  
Bhuvan Kishore ◽  
John Davis ◽  
Katayoun Rezvani ◽  
David Marin ◽  
Richard M Szydlo ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Median Time ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Registry Data ◽  
Cumulative Probability ◽  
Peripheral Blood Stem Cells ◽  
Blood Stem Cells ◽  
Neutrophil Engraftment

Abstract Abstract 4052 Introduction: Donor stem cells are traditionally infused fresh into recipients in the setting of allogeneic hematopoietic stem cell transplantation (allo-SCT). In this study, we investigated outcomes of 133 sibling allografts using cryopreserved peripheral blood stem cells. We demonstrate that cryopreservation did not have a negative impact on engraftment when compared to data from the IBMTR/EBMT, Seattle and the Canadian registry studies. Non-relapse mortality (NRM) and overall survival (OS) were within acceptable limits. Patients and Methods: We identified all recipients of HLA-matched sibling peripheral stem cells cryopreserved for a minimum of 7 days, who underwent allo-SCT at Hammersmith Hospital from January 1998 until May 2011 (n = 133). The median age at allo-SCT of 78 (59 %) males and 55 (41 %) females was 48 (17 – 65) yrs. Thirty-five (26 %) were transplanted for CML (including accelerated and blast phase), 42 (31 %) for AML, 11 (8 %) for ALL, 14 (11 %) for myeloma and 13 (10%) for other causes. Fifty-six (42 %) had myeloablative and 77 (58 %) had reduced intensity conditioning, with 23 (17 %) having in vivo T-cell depletion with monoclonal anti-CD52 antibody (alemtuzumab). Using validated institutional protocols hematopoietic progenitor cell collections were cryopreserved on the day of collection or on following morning. Cells are were mixed with 10 % v/v dimethyl sulfoxide, frozen to -−00°C at a controlled rate and then transferred to vapor phase liquid nitrogen ≤ −150°C. Thawing and infusion of cells were performed in accordance with a standard protocol defining thawing temperature and the maximum time between thawing and infusion. Median CD-34+ cell dose infused was 9.83 × 106/kg (range 2.4 – 33 × 106/kg). All cryopreserved peripheral blood stem cell collections were infused into the recipients. Engraftment was defined as a peripheral absolute neutrophil count (ANC) of 0.5 × 109/L for 2 successive days and platelet count of > 50 × 109/L for 2 consecutive days, both without support. G-CSF was used only in delayed neutrophil engraftment (> 30 days). Results: Overall 125 (93 %) achieved neutrophil engraftment and median time to engraftment was 19 (range 10 – 42) days. Delayed neutrophil engraftment (>30 days) was present in 4 patients. Results are comparable to the registry data which showed neutrophil engraftment in a median of 14 – 19 days (Table 1). Cumulative probability of achieving ANC > of 0.5 × 109/L for the whole cohort was 94 % (88 – 95). Eight of the 133 patients who died early (< day 30) failed to achieve neutrophil engraftment prior to death. The causes of death were sepsis (n = 6), myocardial ischemia (n = 1) and renal failure (n = 1).Three recovered counts with G-CSF and one patient required stem cell rescue. One hundred and thirteen patients (84 %) recovered platelets to >50 × 109/L within a median time of 21 (range 0 – 240) days, which again is similar to registry data as shown in table 1. The cumulative probability of achieving platelets of 50 × 109/L was 84 % (77 – 88). Twenty patients (16 %) failed to achieve this threshold and causes were multiple. There was no association between CD34+ cell doses infused and delayed or non engraftment of platelets. The incidence of acute and chronic GvHD were 44 % (grade II-IV GvHD 31 %) and 30 % (50 % extensive) respectively. Day 100 NRM was 23 % and OS at 3 years was 50 %. Conclusion: This study provides evidence that cryopreservation and subsequent infusion of peripheral blood stem cell harvests is safe, ensures durable engraftment and is comparable to fresh stem cell infusions (Table 1). We do not routinely use growth factors to aid count recovery and as such the time to engraftment data is consistent. Cryopreservation importantly allows for flexibility in arranging admissions and scheduling regimens for both the donors and the transplant units. Although not observed in our cohort, there is a theoretical risk of not utilizing the cryopreserved cells, thus unnecessarily harvesting donors. One way to circumvent this possibility is by timing the collection close to the transplant. Disclosures: No relevant conflicts of interest to declare.

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