Peripheral-blood stem-cell collections after paclitaxel, cyclophosphamide, and recombinant human granulocyte colony-stimulating factor in patients with breast and ovarian cancer.

1995 ◽  
Vol 13 (7) ◽  
pp. 1714-1719 ◽  
Author(s):  
T Demirer ◽  
S Rowley ◽  
C D Buckner ◽  
F R Appelbaum ◽  
K Lilleby ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Breast And Ovarian Cancer ◽  
Peripheral Blood Stem Cells ◽  
Cd34 Cells ◽  
Stimulating Factor

PURPOSE Here we evaluate Taxol (paclitaxel; Bristol-Myers Squibb, Princeton, NJ) and cyclophosphamide (CY) with recombinant human granulocyte colony-stimulating factor (rhG-CSF) for mobilization of peripheral-blood stem cells (PBSCs) for autologous stem-cell transplantation in patients with breast and ovarian cancer. PATIENTS AND METHODS PBSCs were collected from 17 patients with breast (n = 11), ovarian (n = 5), and gastric (n = 1) cancer after administration of Taxol (170 mg/m2 x 1) and CY (4 g/m2 x 1) followed by rhG-CSF (10 micrograms/kg/d). PBSC collections after Taxol and CY were compared with PBSC collections from nine patients with stage IV breast (n = 8) or stage III ovarian (n = 1) cancer who had received CY (4 g/m2 x 1) followed by rhG-CSF (16 micrograms/kg/d) for mobilization. RESULTS Mean WBC and platelet counts on the first day of apheresis were 6.3 x 10(9)/L (range, 1.9 to 22.1) and 35 x 10(9)/L (range, 19 to 77), respectively. The median numbers of CD34+ cells, peripheral-blood mononuclear cells (PBMNC), and peripheral-blood total nucleated cells (PBTNC) collected were 13.02 x 10(6)/kg (range, 5.4 to 57.8; mean, 16.02), 6.86 x 10(8)/kg (range, 1.9 to 51.2), and 17.41 x 10(8)/kg (range, 2.4 to 106.6), respectively. In the comparison group, the median yield of CD34+ cells was 6.39 x 10(6)/kg (range, 0.2 to 28; mean, 10.01; P = .01). The mean daily yield of CD34+ cells/kg/collection was 3.5 (range, 0.8 to 28.9) after Taxol and CY, as compared with 1.3 (range, 0.1 to 7.0) for patients who received CY alone (P = .01). All patients who received CY and Taxol reached a target level of 5 x 10(6) CD34+ cells/kg, as compared with five of nine patients (55.5%) who received CY alone (P = .03). CONCLUSION These data suggest that Taxol and CY followed by rhG-CSF mobilizes PBSCs in patients with advanced breast and ovarian cancer more effectively than this regimen without Taxol.

Circulating Primitive Stem Cells in Paroxysmal Nocturnal Hemoglobinuria (PNH) Are Predominantly Normal in Phenotype But Granulocyte Colony-Stimulating Factor Treatment Mobilizes Mainly PNH Stem Cells

Blood ◽  
1998 ◽  
Vol 91 (12) ◽  
pp. 4504-4508 ◽  
Author(s):  
Roderick J. Johnson ◽  
Andy C. Rawstron ◽  
Steve Richards ◽  
Gareth J. Morgan ◽  
Derek R. Norfolk ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Autologous Transplantation ◽  
Hemopoietic Stem Cell ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Peripheral Blood Stem Cells ◽  
Stimulating Factor

Abstract Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hemolytic anemia resulting from a somatic mutation in a hemopoietic stem cell. In most cases of hemolytic PNH, the majority of the marrow cells are derived from the PNH clone. Recent evidence has indicated, however, that the majority of the most primitive peripheral blood stem cells (PBSCs) in PNH appear to be of normal phenotype. This has led to tentative suggestions that normal PBSCs could be collected and used for autologous transplantation. We have investigated this possibility in four PNH patients by treating them with granulocyte colony-stimulating factor (G-CSF) in an attempt to mobilize normal progenitors. The expression of glycosylphosphatidylinositol (GPI)-linked proteins was analyzed by flow cytometry on mature neutrophils, late stem cells (CD34+/CD38+), and primitive stem cells (CD34+/CD38−). The phenotyping and stem cell quantitation was performed in steady-state blood and post–G-CSF administration. The most primitive PBSCs (CD34+/CD38−) were almost all normal before G-CSF treatment, even when the patients' neutrophils were mainly PNH. However, after G-CSF, the cells that were mobilized into the peripheral blood were of a similar phenotype to the mature neutrophils, ie, mainly PNH. It is possible that PNH-stem cells are preferentially destroyed by complement in the peripheral blood leaving only normal cells in the circulation. After G-CSF, the PNH cells in the marrow are released into the blood. Our findings suggest that it would be difficult to collect sufficient numbers of normal stem cells for autologous transplantation.

Effect of different chemotherapy regimens on peripheral-blood stem-cell collections in patients with breast cancer receiving granulocyte colony-stimulating factor.

1997 ◽  
Vol 15 (2) ◽  
pp. 684-690 ◽  
Author(s):  
T Demirer ◽  
C D Buckner ◽  
B Storer ◽  
K Lilleby ◽  
S Rowley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Reference Group ◽  
Blood Stem Cell ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Cd34 Cells ◽  
Stimulating Factor

PURPOSE To evaluate the effects of chemotherapy regimens on peripheral-blood stem-cell (PBSC) yields in patients with breast cancer who receive granulocyte colony-stimulating factor (G-CSF). PATIENTS AND METHODS One hundred patients with breast cancer received cyclophosphamide 4 g/m2 for dose (CY) (n = 10), CY and etoposide 600 mg/m2 (CE) (n = 13), CE and cisplatin 105 mg/m2 (CEP) (n = 19), or CY and paclitaxel 170 mg/m2 (n = 58), followed by G-CSF. PBSC collections were initiated when the WBC count recovered to greater than 1 x 10(9)/L. A multivariate analysis was undertaken to evaluate the effects of different chemotherapy regimens and patient variables on PBSC collections as measured by the yield of CD34+ cells. RESULTS The medians of average daily CD34+ cell yields for patients who received paclitaxel plus CY, CE, and CEP with G-CSF were 12.9, 11.03, and 5.37 x 10(6)/kg, respectively, compared with 2.02 x 10(6)/kg in the reference group that received CY with G-CSF (P = < .0001, .002, and .09, respectively). On first-day collections, patients who received paclitaxel plus CY, CE, and CEP with G-CSF yielded medians of 11.07, 8.09, and 3.52 x 10(6) CD34+ cells/kg, respectively, compared with 0.90 x 10(6)/kg in the reference group that received CY with G-CSF (P = .0006, .02, and .09, respectively). The number of previous cycles of chemotherapy, previous radiotherapy, marrow involvement, and phase and stage of disease did not have statistically significant effects on CD34+ cell yield. CONCLUSION Combination chemotherapy regimens were superior to single-agent CY for the mobilization of CD34+ cells.

Circulating Primitive Stem Cells in Paroxysmal Nocturnal Hemoglobinuria (PNH) Are Predominantly Normal in Phenotype But Granulocyte Colony-Stimulating Factor Treatment Mobilizes Mainly PNH Stem Cells

Blood ◽  
1998 ◽  
Vol 91 (12) ◽  
pp. 4504-4508
Author(s):  
Roderick J. Johnson ◽  
Andy C. Rawstron ◽  
Steve Richards ◽  
Gareth J. Morgan ◽  
Derek R. Norfolk ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Autologous Transplantation ◽  
Hemopoietic Stem Cell ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Peripheral Blood Stem Cells ◽  
Stimulating Factor

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hemolytic anemia resulting from a somatic mutation in a hemopoietic stem cell. In most cases of hemolytic PNH, the majority of the marrow cells are derived from the PNH clone. Recent evidence has indicated, however, that the majority of the most primitive peripheral blood stem cells (PBSCs) in PNH appear to be of normal phenotype. This has led to tentative suggestions that normal PBSCs could be collected and used for autologous transplantation. We have investigated this possibility in four PNH patients by treating them with granulocyte colony-stimulating factor (G-CSF) in an attempt to mobilize normal progenitors. The expression of glycosylphosphatidylinositol (GPI)-linked proteins was analyzed by flow cytometry on mature neutrophils, late stem cells (CD34+/CD38+), and primitive stem cells (CD34+/CD38−). The phenotyping and stem cell quantitation was performed in steady-state blood and post–G-CSF administration. The most primitive PBSCs (CD34+/CD38−) were almost all normal before G-CSF treatment, even when the patients' neutrophils were mainly PNH. However, after G-CSF, the cells that were mobilized into the peripheral blood were of a similar phenotype to the mature neutrophils, ie, mainly PNH. It is possible that PNH-stem cells are preferentially destroyed by complement in the peripheral blood leaving only normal cells in the circulation. After G-CSF, the PNH cells in the marrow are released into the blood. Our findings suggest that it would be difficult to collect sufficient numbers of normal stem cells for autologous transplantation.

Effective Primary Mobilization of Autologous Peripheral Blood Stem Cells with Granulocyte Colony-Stimulating Factor and Plerixafor in Lenalidomide-Treated Patients with Multiple Myeloma

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2254-2254
Author(s):  
Faiz Anwer ◽  
Myke R Green ◽  
Andrew M. Yeager
Keyword(s):  
Peripheral Blood ◽  
Previous Treatment ◽  
Previous Exposure ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Peripheral Blood Stem Cells ◽  
Cd34 Cells ◽  
Blood Stem Cells ◽  
Stimulating Factor ◽  
Pbsc Mobilization

Abstract Abstract 2254 Background: Lenalidomide (LEN) is extensively used in combination with dexamethasone (DEX), with or without bortezomib (BOR), for initial treatment of multiple myeloma (MM). However, several studies have shown that previous exposure to LEN is associated with impaired collection of autologous peripheral blood stem cells (PBSCs) after mobilization with either granulocyte-colony stimulating factor (G-CSF) or chemotherapy plus G-CSF. The effects of previous exposure to LEN on the collection of autologous PBSCs after mobilization with G-CSF plus plerixafor (PLX; Mozobil®) are not well described. Methods: We evaluated the outcomes of autologous PBSC mobilization and collection in 15 consecutive patients (pts) with MM who received previous treatment with at least 2 21-day cycles of LEN in combination with either DEX (10 pts) or DEX and BOR (5 pts) and who underwent initial autologous PBSC mobilization with G-CSF (10 micrograms/kg/dose subcutaneously daily × 4 days) and PLX (0.24 mg/kg/dose subcutaneously, after fourth dose of G-CSF), with additional doses of G-CSF and PLX for subsequent apheresis sessions. Results: Median age of pts was 58 yr (range, 35–67). Patients received a median of 5 cycles (range, 2–12) of LEN. The median number of apheresis sessions was 1 (range, 1–2). The median level of CD34+ cells in the peripheral blood at day 1 of apheresis was 84.36 per microliter (range, 12.46–167.37), and the median yield of CD34+ cells was 6.52 × 106/kg (range, 1.43–17.11) after day 1 of apheresis and 7.46 × 106/kg (range, 2.32–17.11) after day 2 of apheresis. No LEN-treated pts failed mobilization (defined as collection of less than 2 × 106 CD34+ cells/kg). Eleven pts (73.3%) collected at least 6 × 106/kg CD34+ cells (i.e., sufficient for 2 transplants) after 1 or 2 aphereses, with 8 pts (53.3%) reaching that target after 1 apheresis. Of the 4 pts (26.7%) in whom fewer than 6 × 106/kg CD34+ cells were collected after 2 aphereses, 3 pts collected at least 4 × 106 CD34+ cells/kg, and only 1 pt (who received only 2 cycles of LEN) collected 2.32 × 106/kg CD34+ cells. The number of cycles of LEN did not correlate with concentration of CD34+ cells in peripheral blood on day 1 of apheresis (r2=0.099), yield of CD34+ cells on day 1 of apheresis (r2=0.108), or total yield of CD34+ cells after 2 days of apheresis (r2=0.067). Pts who received 4 or fewer cycles of LEN had higher median circulating CD34+ cells on apheresis day 1, higher median CD34+ cell yield with day 1 apheresis and higher total CD34+ cell yield after 2 aphereses than pts who received more than 4 cycles of LEN (Table). Five of 6 pts who received 4 or fewer cycles of LEN collected at least 6 × 106 CD34+ cells/kg after 1 apheresis, compared with 3 of 9 pts who received more than 4 cycles. However, none of these differences were statistically significant (Table). Conclusions: Previous treatment with LEN does not impair collection of autologous PBSCs after initial mobilization with G-CSF and PLX. However, there was a trend to more robust autologous PBSC collections and decreased need for second aphereses in pts who received fewer cycles of LEN. These findings are consistent with the recommendation of the International Myeloma Working Group to collect autologous PBSCs from MM pts after 4 or fewer cycles of LEN-containing regimens. As mobilization with G-CSF with or without chemotherapy leads to inconsistent autologous PBSC collection in LEN-treated MM pts, our experience supports the use of G-CSF plus PLX as an upfront mobilization strategy for these pts. Disclosures: No relevant conflicts of interest to declare.

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