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Progenitor Cell Mobilisation

Use of concurrent G-CSF + GM-CSF vs G-CSF alone for mobilization of peripheral blood stem cells in children with malignant disease

Bone Marrow Transplantation volume 26, pages 365–369 (2000)Cite this article

Abstract

There is limited experience in the mobilization of peripheral blood progenitor cells (PBPC) in children and the optimal method for PBPC mobilization is unknown. The present study was conducted to ascertain whether mobilization with G-CSF + GM-CSF (group I) provides some advantage over G-CSF alone (group II) in terms of collected CD34+ cells and hematopoietic recovery following myeloablative conditioning in children with malignancies. An economic analysis was also performed. Each group comprised 21 consecutive patients. The mean number of aphereses was 1.5 ± 0.5 in group I and 1.2 ± 0.46 in group II (NS). The mean number of CD34+ cells was 3.8 × 106 ± 4.03/kg in group I and 4.2 ± 5.4 in group II (NS). The mean number of total blood volumes (TBV) processed was 4.4 ± 1.5 in group I and 4.3 ± 1.5 in group II (NS). The mean duration of the procedure was 276 ± 74.1 min in group I and 286.7 ± 75.9 min in group II (NS), and the inlet flow was 45.1 ± 12 ml/min in group I and 39.5 ± 15.1 ml/min in group II (NS). No significant differences in the neutrophil and platelet engraftment probability were observed between the two groups. The mean overall cost of group II was not statistically significant from that of group I (US$ 9521 ± 330 vs US$ 10201 ± 1028, P = NS). The cost of mobilization was significantly higher in group I than in group II, conditioning regimen costs were similar in both groups and the costs related to the post-transplant period were similar in both groups. We conclude that PBPC mobilization with G-CSF + GM-CSF in children does not enhance hematological recovery in comparison with mobilization using G-CSF alone. However, the combination of G-CSF + GM-CSF does not significantly increase the overall cost of transplantation. Bone Marrow Transplantation (2000) 26, 365–369.

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References

  1. Lasky LC, Bostrone B, Smith J et al. Clinical collection and use of peripheral blood stem cell in pediatrics patients Transplantation 1989 47: 613–616

    Article  CAS  PubMed  Google Scholar 

  2. Watanabe T, Takaue Y, Kawano Y et al. Peripheral blood stem cell autotransplantation in treatment of childhood cancer Bone Marrow Transplant 1989 4: 261–265

    CAS  PubMed  Google Scholar 

  3. Díaz MA, Alegre A, Villa M et al. Collection and transplantation of peripheral blood progenitor cells mobilized by G-CSF alone in children with malignancies Br J Haematol 1996 94: 148–154

    Article  PubMed  Google Scholar 

  4. Hohaus S, Goldschmidt H, Ehrahardt R, Haas R . Successful autografting following myeloablative conditioning therapy with blood stem cells mobilized by chemotherapy plus rh G-CSF Exp Hematol 1993 21: 508–514

    CAS  PubMed  Google Scholar 

  5. Kanold J, Rapatel C, Berger M et al. Use of G-CSF alone to mobilize peripheral blood stem cells for collection in children Br J Haematol 1994 88: 633–635

    Article  CAS  PubMed  Google Scholar 

  6. Ravagnani F, Siena S, Bregni M et al. Large-scale collection of circulating hematopoietic progenitors in cancer patients treated with high-dose cyclophosphamide and recombinant human GM-CSF Eur J Cancer 1990 26: 562–564

    Article  CAS  PubMed  Google Scholar 

  7. Bensinger W, Singer J, Appelbaum F et al. Autologous transplantation with peripheral blood mononuclear cells collected after administration of recombinant granulocyte stimulating factor Blood 1993 81: 3158–3165

    CAS  PubMed  Google Scholar 

  8. Sheridan WP, Begley GG, Grigg A et al. Phase II study of autologous filgastrim (G-CSF) mobilized peripheral blood progenitor cells to restore hemopoiesis after high-dose chemotherapy for lymphoid malignancies Bone Marrow Transplant 1994 14: 105–111

    CAS  PubMed  Google Scholar 

  9. Weaver CH, Schulman K, Wilson-Relyea B et al. Randomized trial of filgrastim, sargramostim or sequential sargramostim and filgrastim after myelosuppressive chemotherapy from the harvesting of peripheral-blood stem cells J Clin Oncol 2000 18: 43–53

    Article  CAS  PubMed  Google Scholar 

  10. Rosenfeld CS, Bolwell B, Lefever A et al. Comparison of four cytokine regimens for mobilization of peripheral blood stem cells: IL-3 alone and combined with GM-CSF or G-CSF Bone Marrow Transplant 1996 17: 179–183

    CAS  PubMed  Google Scholar 

  11. Begley CG, Basser R, Mansfield R et al. Enhanced levels and enhanced clonogenic capacity of blood progenitor cells following administration of stem cell factor plus granulocyte colony-stimulating factor to humans Blood 1997 90: 3378–3389

    CAS  PubMed  Google Scholar 

  12. Shpall E, Wheeler C, Turner S et al. A randomized phase 3 study of peripheral blood progenitor cell mobilization with stem cell factor and filgrastim in high-risk breast cancer patients Blood 1999 93: 2491–2501

    CAS  PubMed  Google Scholar 

  13. Díaz MA, Villa M, Madero L et al. Analysis of engraftment kinetics in pediatric patients undergoing autologous PBPC transplantation J Hematother 1998 7: 367–373

    Article  PubMed  Google Scholar 

  14. Díaz MA, Alegre A, Villa M et al. Pediatric blood progenitor cell transplantation: influence of CD34+ cell dose in engraftment kinetics Bone Marrow Transplant 1996 18: 699–703

    PubMed  Google Scholar 

  15. Bot FS, Van Eijk L, Schipper P et al. Synergistic effects between GM-CSF and G-CSF or M-CSF on highly enriched human marrow progenitor cells Leukemia 1990 4: 325–328

    CAS  PubMed  Google Scholar 

  16. Takaue Y, Kawano Y, Abe T et al. Collection and transplantation of peripheral blood stem cells in very small children weight 20 kg or less Blood 1995 86: 372–376

    CAS  PubMed  Google Scholar 

  17. Takaue Y, Watanabe T, Abe T et al. Experience with peripheral blood stem cell collection for autografts in children with active cancer Bone Marrow Transplant 1992 10: 241–246

    CAS  PubMed  Google Scholar 

  18. Alegre A, Díaz MA, Madero L et al. Large volume leukapheresis for peripheral blood stem cell collection in children: a simplified single apheresis approach Bone Marrow Transplant 1996 17: 923–927

    CAS  PubMed  Google Scholar 

  19. Díaz MA, Alegre A, Benito A . Peripheral blood progenitor cell collection by large volume leukapheresis in low-weight children J Hematother 1998 7: 63–68

    Article  PubMed  Google Scholar 

  20. Kawano Y, Takaue Y, Watanabe T et al. Effects of progenitor cells dose and preleukapheresis use of human recombinant granulocyte colony-stimulating factor on recovery of hematopoiesis after blood stem cells autografting in children Exp Hematol 1993 21: 103–107

    CAS  PubMed  Google Scholar 

  21. Leibundgut K, Von Rohr A, Brulhart K et al. The number of circulating CD34+ blood cells predicts the colony forming capacity of leukapheresis products in children Bone Marrow Transplant 1995 15: 25–31

    CAS  PubMed  Google Scholar 

  22. Klingebiel T, Handgretinger R, Herter M et al. Autologous transplantation with peripheral blood stem cells in children and youngs adults after myeloablative treatment: non randomized comparison between GM-CSF and G-CSF for mobilization J Hematother 1995 4: 307–314

    Article  CAS  PubMed  Google Scholar 

  23. Bensinger W, Longing K, Appelbaum F et al. Peripheral blood stem cells (PBSC) collected after recombinant granulocyte colony-stimulating factor (rh G-CSF): an analysis of factors correlating with the tempo of engraftment after transplantation Br J Haematol 1994 87: 825–830

    Article  CAS  PubMed  Google Scholar 

  24. Bensinger W, Appelbaum F, Rowley S et al. Factors that influence collection and engraftment of autologous peripheral blood stem cells J Clin Oncol 1995 13: 2547–2552

    Article  CAS  PubMed  Google Scholar 

  25. Spitzer G, Adkins D, Mathews M et al. Randomized comparison of G-CSF + GM-CSF vs G-CSF alone for mobilization of peripheral blood stem cells: effects on hematopoietic recovery after high-dose chemotherapy Bone Marrow Transplant 1997 20: 921–930

    Article  CAS  PubMed  Google Scholar 

  26. Bashey A, Corringham S, Fields KK et al. Use of concurrent GM-CSF and G-CSF administration to re-mobilize patients who fail initial mobilization: results on twenty-three patients from two centers Blood 1999 94: (Suppl. 1) 327a(Abstr. 1463)

    Google Scholar 

  27. Waters JM, Bennett CL, Pejeau TS et al. Economic analysis of bone marrow and blood stem cell transplantation for leukemias and lymphoma: what do we know? Bone Marrow Transplant 1998 21: 641–650

    Article  CAS  PubMed  Google Scholar 

  28. Hartman O, Le Coroller AG, Blaise D et al. Peripheral blood stem cell and bone marrow transplantation for solid tumors and lymphomas: hematologic recovery and costs Ann Intern Med 1997 126: 600–607

    Article  Google Scholar 

  29. Dufoir T, Sanx MC, Terraza B et al. Comparative cost of allogeneic or autologous bone marrow transplantation and chemotherapy in patients with acute myeloid leukemia in first remission Bone Marrow Transplant 1992 10: 323–329

    CAS  PubMed  Google Scholar 

  30. Smith TJ, Hillner BE, Schmitz N et al. Economic analysis of a randomized clinical trial to compare filgastrim-mobilized peripheral-blood progenitor cell transplantation and autologous bone marrow transplantation in patients with Hodgkin's and non-Hodgkin's lymphoma J Clin Oncol 1997 15: 5–10

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Bone Marrow Transplantation Unit, Hospital Niño Jesús, Universidad Autónoma de Madrid, Madrid, Spain

    L Madero, M González-Vicent, J Molina, R Madero, V Quintero & MA Díaz

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  1. L Madero
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  2. M González-Vicent
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  4. R Madero
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Madero, L., González-Vicent, M., Molina, J. et al. Use of concurrent G-CSF + GM-CSF vs G-CSF alone for mobilization of peripheral blood stem cells in children with malignant disease. Bone Marrow Transplant 26, 365–369 (2000). https://doi.org/10.1038/sj.bmt.1702523

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