PERIPHERAL-BLOOD STEM-CELLS (PBSCS) COLLECTED AFTER RECOMBINANT GRANULOCYTE-COLONY-STIMULATING FACTOR (RHG-CSF) - AN ANALYSIS OF FACTORS CORRELATING WITH THE TEMPO OF ENGRAFTMENT AFTER TRANSPLANTATION

被引:301
作者
BENSINGER, WI
LONGIN, K
APPELBAUM, F
ROWLEY, S
WEAVER, C
LILLEBY, K
GOOLEY, T
LYNCH, M
HIGANO, T
KLARNET, J
CHAUNCEY, T
STORB, R
BUCKNER, CD
机构
[1] VET ADM MED CTR,SEATTLE,WA
[2] UNIV WASHINGTON,SEATTLE,WA
关键词
MARROW TRANSPLANTATION; PERIPHERAL BLOOD STEM CELLS; G-CSF;
D O I
10.1111/j.1365-2141.1994.tb06744.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Factors affecting mobilization and engraftment were analysed in 54 patients undergoing transplant using autologous PBSCs mobilized with high-dose recombinant granulocyte stimulating factor (rhG-CSF). Patients received 5-7d of rhG-CSF, 16 mu g/kg/d, administered subcutaneously. PBSCs were harvested by leukapheresis using automated continuous-flow blood cell separators beginning on day 4 of rhG-CSF, processing 10 litres of whole blood, for 2-6 consecutive days. Transplants were performed for the following diseases: breast cancer (n = 22), non-Hodgkin's lymphoma (n = 18), multiple myeloma (n = 7) and other (n = 7). Engraftment: was rapid with patients reaching a neutrophil count of 1 x 10(9)/l a median of 12 d (range 9-22) after transplant. Platelets > 20 x 10(9)/l independent of transfusion support were achieved a median of day 10 (range 7-60) after infusion. Multiple factors potentially influencing engraftment were examined using a Cox regression model. The number of CD34(+) cells per kg was highly correlated with the time to achievement of granulocyte and platelet recovery (P < 0.012, 0.0001). The use of a post-infusion growth factor and a radiation preparative regimen was important for neutrophil recovery, and a diagnosis of breast cancer was important for platelet recovery. In an analysis by linear regression of the logarithm of CD34(+) cells collected, lower age, marrow without disease, no prior radiation, and lower number of prior chemotherapy regimens, were important factors influencing larger numbers of CD34(+) cells in collections.
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页码:825 / 831
页数:7
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