GRANULOCYTE-COLONY-STIMULATING FACTOR GIVEN IN ADDITION TO INTERFERON-ALPHA TO MOBILIZE PERIPHERAL-BLOOD STEM-CELLS FOR AUTOLOGOUS TRANSPLANTATION IN CHRONIC MYELOID-LEUKEMIA
E. Archimbaud et al., GRANULOCYTE-COLONY-STIMULATING FACTOR GIVEN IN ADDITION TO INTERFERON-ALPHA TO MOBILIZE PERIPHERAL-BLOOD STEM-CELLS FOR AUTOLOGOUS TRANSPLANTATION IN CHRONIC MYELOID-LEUKEMIA, British Journal of Haematology, 99(3), 1997, pp. 678-684
In order to potentially mobilize and harvest the Ph- cells observed in
most patients with chronic myeloid leukaemia (CML) during interferon-
alpha (IF-alpha) therapy, G-CSF (filgrastim), 5 mu g/kg/d, was adminis
tered subcutaneously together with IF-alpha to 30 CML patients in haem
atological remission but with various degrees of cytogenetic remission
, after IF-alpha therapy. Peripheral blood stem cells (PBSC) were harv
ested using standard aphereses from day 5 of G-CSF. Patients underwent
one to four (median three) aphereses. Median total yields/kg were 7.6
(range 3.8-25) x 10(8) MNC, 3.4 (0-140) x 10(6) CD34(+) cells, and 17
(1.1-107) x 10(4) CFU-GM, No patient had a significant increase in th
e percentage of Ph+ cells in the bone marrow under G-CSF therapy The p
ercentage of Ph+ cells in apheresis products tended to decrease betwee
n the first and the last apheresis (P=0.05). 14 patients who were not
responsive to IF-alpha were transplanted after conditioning with busul
phan 16 mg/kg and melphalan 140 mg/m(2). Median time to neutrophils >
0.5 x 10(9)/l was 20 d (16-114 d) and to platelets >50 x 10(9)/l 18 d
(12-149 d), Nine patients had a major cytogenetic response post graft,
which correlated with the amount of Ph+ cells reinfused with the graf
t (P = 0.02). We conclude that this procedure is feasible, allowing th
e harvest of enough PBSC, some of them Ph- in patients who responded t
o IF-alpha, to allow autologous transplantation.