MULTI-DAY INFUSION OF AUTOLOGOUS CRYOPRESERVED PERIPHERAL BLOOD PROGENITOR CELLS IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES -TNE INFLUENCE ON ENGRAFTMENT TOXICITY

Journal
Haematologica, the hematology journal
Date Issued
2005-06
Author(s)
Cevreska, Lidija
Siljanoski, Nikola
Abstract
Peripheral blood progenitor cells (PBPC) are increasingly used
as source of stem cells in both autologous and allogeneic settings
for patients with hematological malignancies. Based on previously
non-randomized studies for enhanced engraftment during multi-day
infusion of cryopreserved PBPC in the autologous
transplantation, some transplant centers infuse harvests over 3
days. To evaluate the benefit of fractionated infusions of PBPC
we included 37 patients with hematological malignancies (AML
11, NHL 9, HD 9, MM 6, ALL 2) treated with high-dose
chemotherapy (HD1) followed by autologous stem cell trans·
plantation (ASC1) at Department of hematology, Skopje, Macedonia.
The patients were randomized to receive cryopreserved
PBPC concentrates divided over 1,2 or more than 3 days. PBPC
were mobilized with high-dose VPI6 2g/m' for AML patients,
intermediate-dose cyclophosphamide 1-2 g/m' for lymphoproliferative
malignancies and/or G-CSF 5microgrlkg alone. PBPC
concentrates were cryopreserved with 5% DMSO solutions
using controlled rate freezing procedures (Nicole plus PC Espace
330. Patients received daily G-CSF 10microgr/kg i,v over 30 min
beginning 4h after the infusion of the first aliquot of PBPCs.
The median amount of infused PBPC solution was 430 ml (240-
780ml). Engraftment was registered for Ne>0.5xl <Y/L on day
+ 10 (8- 14) and for Plt>20xl0'1L on day + 13 (8-20) with no sasystical
difference between groups that received I, 2 or more than
3 days infusions of PBPCs. Transfusion requirements were for
Er 2 doses (0-4) and Plt 14 doses (O-33). The statistical data
revealed that infusion related toxicity was similar for all groups
of patients. At the end we can conclude that multi-day infusion
of PBPC harvests does not influence the engraftment or reduce
toxicity.
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