A successful and simplified filgrastim primed single apheresis method without large volume apheresis for peripheral blood stem cell collection

Background: There is a tendency to use only one apheresis collection to red uce the morbidity and the cost of peripheral blood stem cell collection. We studied whether rapid and complete engraftment could be achieved by single apheresis by using only Filgrastim without large volume apheresis in previ ously treated patients. Methods: Engraftment of single apheresis in 25 patients was compared with t hose of multiple apheresis in 26 patients; 52% of patients in the single ap heresis group and 62% of patients in the multiple apheresis group were heav ily pretreated. All patients received 10-15 mu g/kg/day of Filgrastim start ing on day 14 after 3-4 cycles of induction chemotherapy. Apheresis was per formed using Cobe Spectra on day 4, 5 or 6 in the single apheresis group an d every other day in the multiple apheresis group after day 3. Results: The median collection volume was 250 ml (250-300 ml) in the single apheresis group and 750 ml (200-1500 ml) in the multiple apheresis group. The median CD34(+) cell number was not significantly different in the two g roups (11.79 vs 9.38 x 10(6)/kg). The median times to achieve leukocytes > 1 x 10(9)/l and platelets 250 x 10(9)/l counts were 10 days (8-21 days) and 15 days (9-38 days) in the single apheresis group vs 11 days (8-23 days) a nd 20 days (1032 days) in the multiple apheresis group, respectively (p < 0 .05). Antibiotic use was less in the single apheresis group than the multip le apheresis group (9 vs 12 days, p < 0.05). Conclusion: Adequate numbers of peripheral stem cells were harvested by G-C SF in a single apheresis without large volume apheresis even in heavily pre treated patients. Rapid and complete engraftment occurred in all patients a nd it was faster in single than multiple apheresis.