Optimising parameters for peripheral blood leukapheresis after r-metHuG-CSF (filgrastim) and r-metHuSCF (ancestim) in patients with multiple myeloma: A temporal analysis of CD34+ absolute counts and subsets

I. H. Chin-Yee, M. Keeney, A. K. Stewart, A. Belch, I. Bence-Buckler, S. Couban, K. Howson-Jan, M. Rubinger, D. Stewart, R. Sutherland, V. Paragamian, M. Bhatia, R. Foley

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Patients (n = 69) with multiple myeloma undergoing peripheral blood stem cell collection (PBSC) were treated with cyclophosphamide and a combination of recombinant methionyl human granulocyte colony-stimulating factor (r-metHuG-CSF, filgrastim) and recombinant methionyl human stem cell factor (r-metHuSCF, ancestim). The objectives of this study were to determine: (1) The proportion of patients reaching a target yield of ≥5 × 106 CD34+ cells/kg in one or two successive large-volume (20 liter) leukapheresis procedures; (2) the optimal collection time for leukapheresis; (3) mobilization kinetics of CD34+ subsets in response to GCSF/SCF. All patients were mobilized with cyclophosphamide (2.5 g/m2) on day 0 followed by filgrastim (10 μg/kg ) plus ancestim (20 μg/kg) commencing day 1 and continuing to day 11 or 12. Of the 65 evaluable patients, 57 were considered not heavily pretreated and 96.5% obtained a target of ≥5 × 106/kg in one collection. The median CD34+ cells/kg was 39.5 × 106 (range: 5.2-221.2 × 106). Subset analysis demonstrated the number of CD38-, CD33-, and CD133+ peaked at day 11; and CD34+, CD90+ cells peaked at day 10. The optimum day for leukapheresis was determined to be day 11. The median absolute peripheral blood CD34+ cell numbers on day 11 was 665 × 106/l (range: 76-1481 × 106/l). Eight of the 10 heavily pretreated patients were evaluable: three achieved the target dose in one leukapheresis (37.5%) and three (37.5%) achieved the target dose with two leukaphereses. Use of this mobilization strategy allowed the collection of high numbers of CD34+ cells and early progenitors and the ability to predictably schedule leukapheresis.

Original languageEnglish (US)
Pages (from-to)851-860
Number of pages10
JournalBone Marrow Transplantation
Volume30
Issue number12
DOIs
StatePublished - Dec 1 2002

Keywords

  • CD34 subsets
  • G-CSF
  • Multiple myeloma
  • SCF
  • Stem cell mobilization

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Chin-Yee, I. H., Keeney, M., Stewart, A. K., Belch, A., Bence-Buckler, I., Couban, S., Howson-Jan, K., Rubinger, M., Stewart, D., Sutherland, R., Paragamian, V., Bhatia, M., & Foley, R. (2002). Optimising parameters for peripheral blood leukapheresis after r-metHuG-CSF (filgrastim) and r-metHuSCF (ancestim) in patients with multiple myeloma: A temporal analysis of CD34+ absolute counts and subsets. Bone Marrow Transplantation, 30(12), 851-860. https://doi.org/10.1038/sj.bmt.1703765