G-CSF (FILGRASTIM)-STIMULATED WHOLE-BLOOD KEPT UNPROCESSED AT 4-DEGREES-C DOES SUPPORT A BEAM-LIKE REGIMEN IN BAD-RISK LYMPHOMA

The purpose of this study was to demonstrate the reconstitutive potent ial of granulocyte colony-stimulating factor (G-CSF) (filgrastim; Neup ogen-primed unprocessed whole blood after myelotoxic therapy in bad-ri sk lymphoma, Nine patients,vith resistant lymphoma were treated with B AM: a BEAM regimen modified to a 72 h course consisting of BCNU 300 mg /m(2) i.v. (day 1), Ara-C 3000 mg/m(2) i.v. q 12 h (day 2) and melphal an 140 mg/m(2) i.v. (day 3), After 5 days stimulation with G-CSF (10 m u g/kg) 1 l of blood was drawn, kept unprocessed for 3 days and reinfu sed 24 h after completion of chemotherapy, Back-up peripheral stem cel ls were available for all patients, The neutrophil count reached 0.5 x 10(9)/l at a median of 16 days (range 11-25) and a platelet count of 10 x 10(9)/l was reached at a median of 20 days (range 11-NR (not reac hed)), The median length of hospital stay was short in these patients with a median of 19 days (range 17-33), In three patients platelet tra nsfusion independence did not occur before day 28, Those patients rece ived their back-up stem cells, Antibiotics had to be used in two patie nts, The median number of reinfused CD34(+) cells was 0.28 x 10(6)/kg (range 0.01-0.59), When more than 0.2 x 10(6)/kg CD34(+) cells were re infused the time to recovery was comparable to that observed after 'cl assical PBSCT'. In conclusion, the use of G-CSF-stimulated unprocessed whole blood is easy to perform and a cheap technique to mobilize and collect stem cells that can serve as a stem cell source after severe m yelotoxic therapy in bad-risk malignant lymphoma.