Ex vivo expanded peripheral blood progenitor cells provide rapid neutrophil recovery after high-dose chemotherapy in patients with breast cancer

Ex vivo expanded peripheral blood progenitor cells (PBPCs) have been propos ed as a source of hematopoietic support to decrease or eliminate the period of neutropenia after high-dose chemotherapy. CD34 cells were selected from rhG-CSF mobilized PBPCs from patients with breast cancer and were cultured for 10 days in defined media containing 100 ng/mL each of rhSCF, rhG-CSF, and PEG-rhMGDF in 1 L Teflon bags at 20 000 cells/mL. After culture the cel ls were washed and reinfused on day 0 of transplantation. On day +1, cohort 1 patients (n = 10) also received an unexpanded CD34-selected PBPC product . These patients engrafted neutrophils (absolute neutrophil count, >500/muL ) in a median of 6 (range, 5-14) days. Cohort 2 patients (0 = 11), who rece ived expanded PBPCs only, engrafted neutrophils in a median of 8 (range, 4- 16) days. In comparison, the median time to neutrophil engraftment in a his torical control group of patients (0 = 100) was 9 days (range, 7-30 days). All surviving patients are now past the Ii-month posttransplantation stage with no evidence of late graft failure. The total number of nucleated cells harvested after expansion culture was shown to be the best predictor of ti me to neutrophil engraftment, with all patients receiving more than 4 x 10( 7) cells/kg, engrafting neutrophils by day 8. No significant effect on plat elet recovery was observed in any patient. These data demonstrate that PBPC s expanded under the conditions defined can shorten the time to engraftment of neutrophils compared with historical controls and that the rate of engr aftment is related to the dose of expanded cells transplanted. (C) 2000 by The American Society of Hematology.