Transplantation potential of peripheral whole blood primed by VACOP-B chemotherapy plus filgrastim (r-metHuG-CSF) in patients with aggressive non-Hodgkin's lymphoma

Large volumes of peripheral blood need to be processed to obtain sufficient stem cells for hematopoietic rescue after myeloablation, and more than one leukapheresis is necessary in most patients. We conceived the feasibility of harvesting sufficient numbers of hematopoietic cells from the whole bloo d, obtainable by venaepunctures, of patients treated with a standard dose c hemotherapy regimen for high-grade non-Hodgkin's lymphoma. We evaluated the kinetics of mobilization, amount and quality of hematopoietic cells releas ed into circulation during VACOB-B chemotherapy (which consists of a 12-wee k program), and G-CSF in 6 patients with aggressive non-Hodgkin's lymphoma. The median number of granulocyte-macrophage colony-forming cells (GM-CFC) x 10(3)/ml of blood (range), were 1.9 (0.3-8), and 1.16 (0.2-3.2) after the 7th and 11th weekly dose of drugs, respectively, showing an increase of 19 - and 12-fold over patients' prechemotherapy values and of 53- and 33-fold over normal controls (p < 0.001). The median number of CD34(+) cells x 103/ ml of blood (range), at the 7th and 11th cycle, was 135 (53.7-240.9) and 79 .8 (69-173.5), respectively, showing an increase of 10- and 13-fold over pa tients prechemotherapy values (p <less than or equal to> 0.04) and of 300- and 179-fold over normal controls (p less than or equal to 0.001). Long-ter m culture initiating cells (LTC-IC) were released into circulation together with hematopoietic progenitors. We estimated that 1 liter of peripheral bl ood could yield on average 1.8 x 10(6)/kg CD34(+) cells and 2 x 10(4)/kg GM -CFC with LTC-IC frequency comparable to a bone marrow harvest. These figur es may be considered sufficient for hematopoietic rescue after myeloablatio n or hematopoietic support after high-dose chemotherapy.