COMPARISON OF AUTOGRAFTING USING MOBILIZED PERIPHERAL-BLOOD STEM-CELLS WITH AND WITHOUT GRANULOCYTE-COLONY-STIMULATING FACTOR IN MALIGNANT-LYMPHOMAS

Peripheral blood is becoming widely used as the only source of hematop oietic stem cells to support marrow ablative therapy in advanced lymph oma. We report data from 23 patients with high risk non-Hodgkin's (n = 19) and Hodgkin's lymphoma (n = 4) who underwent high-dose therapy wi th mobilized peripheral blood stem cell (PBSC) autografting. Periphera l blood progenitors were recruited using cytotoxic chemotherapy follow ed by administration of recombinant human G-CSF (filgrastim 5 mu g/kg/ day). Myeloablative treatment with autologous PBSC support was adminis trated to the 23 patients and followed by G-CSF at the same dose after cell reinjection. Hematopoietic reconstitution was compared with a co ntrol group of lymphoma patients who received chemotherapy mobilized P BSC transplantation but without G-CSF prior to leukaphereses or after high-dose therapy. The median time to neutrophil recovery >0.5 x 10(9) /l was significantly shorter in study patients compared with the contr ol patients (10 days and 17 days respectively) (p < 0.05). Self sustai ning platelet counts of > 50 x 10(9)/l occurred at a median time of 17 days in both groups. Stable hemopoietic reconstitution was seen with a follow-up of 6 months after PBSC transplantation. In addition, a sig nificant relationship was observed between the number of CFU-GM infuse d and the time to platelet recovery. We confirm the effectiveness of G -CSF given prior to PBSC harvesting in generating high numbers of prog enitor cells. Hematologic recovery following high-dose therapy was imp roved after PBSC rescue and G-CSF.