Kinetics of peripheral blood stem cell mobilization following G-CSF-supported chemotherapy

Stem Cells. 2003;21(5):568-74. doi: 10.1634/stemcells.21-5-568.

Abstract

It would be a clinical and economical advantage if the optimal time point of peripheral blood stem cell (PBSC) mobilization following G-CSF-supported chemotherapy (CT) was known in advance. Therefore, we retrospectively analyzed mobilization parameters in 113 adult tumor patients treated in our institution within 1 year. The start of apheresis was guided by CD34(+) cell measurements in the PB and occurred on or after day 11 after start of mobilization CT in 97% of patients. The median peak (p)CD34(+) cell count in PB uniformly occurred on day 14-15 (range: 6-32 days) after the start of CT, irrespective of the diagnosis (multiple myeloma n = 76, other histology n = 37), the type, but not the amount, of premobilization CT or radiotherapy (RT), the mobilization regimen, or the G-CSF dosage administered. Among more heavily pretreated patients (>six cycles of prior CT or RT), a higher proportion mobilized late (pCD34(+) cell count later than day 20 in 12% and 13%, respectively, versus 2%-5% in the other groups). Therefore, we propose to start measuring CD34(+) cells in the PB on day 11 after the start of mobilization therapy. The wide range of optimal mobilization time points argues for an individualized rather than a preset start of apheresis.

MeSH terms

  • Adult
  • Antigens, CD34 / analysis
  • Antigens, CD34 / biosynthesis
  • Blood Component Removal
  • Combined Modality Therapy
  • Female
  • Granulocyte-Macrophage Colony-Stimulating Factor / administration & dosage
  • Granulocyte-Macrophage Colony-Stimulating Factor / pharmacology
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use*
  • Hematopoietic Stem Cell Mobilization*
  • Humans
  • Kinetics
  • Leukemia / drug therapy
  • Lymphoma / drug therapy
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy
  • Neoplasms / drug therapy
  • Neoplasms / radiotherapy
  • Neoplasms / therapy*
  • Peripheral Blood Stem Cell Transplantation
  • Retrospective Studies
  • Stem Cells / chemistry
  • Stem Cells / cytology

Substances

  • Antigens, CD34
  • Granulocyte-Macrophage Colony-Stimulating Factor