MOBILIZATION OF PERIPHERAL-BLOOD PROGENITOR CELLS BY DISEASE-SPECIFICCHEMOTHERAPY IN PATIENTS WITH SOFT-TISSUE SARCOMA

We investigated peripheral blood progenitor cell (PBPC) mobilization b y disease-specific chemotherapy in patients with metastatic soft tissu e sarcoma (STS), Nine patients, five females and four males, aged 12-5 1 Sears, pretreated by one to nine courses of cytotoxic chemotherapy, underwent STS-specific mobilization followed by G-CSF at 5 mu g/kg/day . PBPC were collected by 19 conventional-volume aphereses (8-12 I) wit h one to four procedures in individual patients. Leukaphereses started on median day 15 (range 13-18) from the first day of mobilization che motherapy at medians of 25.8 x 10(3) WBC/mu l (6.8-46.9), 3.5 x 10(3) MNC/mu l (1.1-8.8), 122 x 10(3) platelets/mu l (72-293) and 30.7 CD34( +) cells/mu l (6.7-207.8). Cumulative harvests resulted in medians of 4.6 x 10(8) MNC/kg (3.0-6.4), 2.9 x 10(6) CD34(+) cells/kg (1.1-11.1) and 12.0 x 10(4) CFU-GM/kg (2.0-37.8). Eight patients underwent high-d ose chemotherapy (HDCT) followed by PBPC rescue. Seven patients recove red hematopoiesis at medians of 12 days (8-15) for ANC >0.5 x 10(3)/mu l and 14 days (8-27) for platelets >20 x 10(3)/mu l. One patient, who received 1.6 x 10(6) CD34(+) cells/kg, exhibited delayed ANC recovery on day +37 and failed to recover platelets until hospital discharge o n day +55, We conclude that in patients with metastatic STS, who are p retreated by standard chemotherapy, PBPC can be mobilized by a further course of STS-specific chemotherapy plus G-CSF. One to four conventio nal-volume aphereses result in PBPC autografts that can serve as hemat opoietic rescue for patients scheduled for HDCT.