Non-cryopreserved unmanipulated hematopoietic peripheral blood stem cell autotransplant program: Long-term results

Background. Methods to simplify bone marrow transplantation procedures are needed mainly in developing countries. Methods. Between May 1993 and February 1999 in a private-practice setting, we performed 29 autotransplants in 28 patients using non-cryopreserved and unmanipulated peripheral blood stem cells mobilized from the bone mat-row t o the peripheral blood by means of hematopoietic growth factors. The autogr afting procedure was performed entirely on an outpatient basis in 19 cases (65%). The median age of the patients was 30 years, with a range of 9-67. T here were 15 patients with acute leukemia (9 with acute my elogenous leukem ia), 3 with chronic myelogenous leukemia, 2 with multiple myeloma, 3 with H odgkin's disease, 2 with non-Hodgkin's lymphoma, and 4 with metastatic brea st carcinoma. Results. The median time to achieve >0.5 X 10(9)/L granulocytes was 14 days (range 7-42), whereas the median time to achieve >20 X 10(9)/L platelets w as 20 days (range 5-49). The 64-month post-transplant survival was 38%, whe reas the median post-transplant survival was 18 months. The transplant-rela ted mortality was 3.4%. The approximate cost of this simplified procedure w as 10.8% for in-hospital procedures and for outpatient autografts, substant ially lower than figures reported from the U.S. for autotransplants, Conclusions. This simplified method for autografting patients, avoiding in- hospital stays, purging procedures and cryopreservation of the cells is fea sible and results in a substantial decrease of the cost of autologous hemat opoietic stem cell transplantation methods. (C) 1999 IMSS. Published by Els evier Science Inc.