CD34(-SELECTED AUTOLOGOUS PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION (PBSCT) IN PATIENTS WITH POOR-RISK HEMATOLOGICAL MALIGNANCIES AND SOLID TUMORS - A SINGLE-CENTER EXPERIENCE())

Between July 1994 and December 1996, PBSC were mobilized in 28 patient s with poor-risk hematological malignancies and solid tumors, CD34(+) cells were positively immunoselected using the Ceprate CS System, By D ecember 1996, 22 patients had been reinfused with a median of 3.325 (0 .078-9.5) x 10(6)/kg CD34(+) cells. In three patients unselected back- up PBSC had to be transfused along with selected CD34(+) cells because of a CD34(+) cell number <0.5 x 10(6)/kg, G-CSF (10 mu g/kg) was star ted on day +1 and all patients engrafted within a median day number of 12 (range, 10-22) until leukocytes >1.0 x 10(9)/l and a median day nu mber of 56 (range, 10-180) until platelets >20.0 x 10(9)/l (ie platele t transfusion independence), Time to leukocyte and platelet recovery w as significantly shorter in patients receiving >2.0 x 10(6)/kg purifie d CD34(+) cells as compared to patients reinfused with <2.0 x 10(6)/kg CD34(+) cells. The hematopoietic recovery time was similar to that of 18 historical control patients treated with unseparated ABMT +/- PBSC T with the exception of a significantly faster leukocyte engraftment i n patients receiving >2.0 x 10(6)/kg CD34(+) cells and a significantly delayed platelet recovery time in patients receiving <2.0 x 10(6)/kg purified CD34(+) cells, There was a trend for a better overall surviva l and a lower probability of progression/relapse as compared to the hi storical controls, We observed five episodes of serious opportunistic infections (three pulmonary fungal infections, two cases of cryptospor idiosis) after the take, Four of these patients had been reinfused wit h <2.0 x 10(6)/kg CD34(+) cells probably indicating a delayed immune r econstitution after CD34(+)-selected PBSCT.