PERIPHERAL-BLOOD PROGENITOR-CELL (PBPC) TRANSPLANTATION WITH A SINGLEAPHERESIS IN PATIENTS WITH LYMPHOMA, MYELOMA AND SOLID TUMORS

The aim of this study was to investigate if a single apheresis after p eripheral blood progenitor cell (PBPC) mobilization can be used to res cue patients receiving high dose chemotherapy (HD.CHE) as treatment fo r an underlying malignancy. Eighteen consecutive patients who were adm itted to the transplant unit for treatment were leukapheresed followin g mobilization with one of the following protocols: group I: rHuG-CSF alone, group II: conventional chemotherapy (C.CHE)+rHuG-CSF or rHuGM-C SF and group III: high dose cytoxan (HD.CTX)+rHuG-CSF. The optimal day for leukapheresis was determined by following white blood cell counts (WBC), mononuclear cell counts (MNC) and CD34(+) cell counts daily. G ranulocyte-macrophage colony-forming cells (GM-CFC) assay was performe d at the leukapheresis product and prior to reinfusion. All patients p roceeded directly to ablative therapy according to their underlying ma lignancy. PBPC from single apheresis were reinfused to all patients an d cytokines started 24 h after infusion. Hematologic recovery after HD .CHE was the parameter used to ensure successful engraftment. We have been able to recover adequate number of PBPC for transplantation with a single apheresis in all patients. The number of infused cells were f or groups I, II and III: (I) median number of MNC 4.7, 3.58 and 2.79 x 10(8)/kg, respectively (2); median number of CD34(+) cells 4.4, 2.8, 2.7 x 10(6)/kg, respectively. The median apheresis day was 6, 16 and 1 6, respectively. Recovery times to granulocyte count >0.5 x 10(9)/L wa s 9 d (range 9-12) and to platelets >20 x 10(9)/L was 12 d (range 1-13 5); 17/18 patients have engrafted successfully independent of the mobi lization method used. These data suggest that sufficient PBPC can be h arvested at a single leukapheresis for hemopoietic rescue after myeloa blative therapy. Rapid hematologic recovery occurs when cytokines alon e after conventional or HD.CHE are used for mobilization. Results of c ollection products and hematopoietic recovery are independent of the m obilization technique used.