Hemopoietic stem-cell harvesting and transplantation using G-CSF-primed BM: comparison with unprimed BM and G-CSF-primed PBSC.

BACKGROUND: PBSC collected following G-CSF priming lead to more rapid hemopoietic reconstitution (HR) after autologous transplantation than do unprimed BMstem cells. However, PBSC have a number of disadvantages compared with BM cells, including the need for an extended collection period and requirement for good venous access. METHODS: We retrospectively analysed our experience with an alternative source of hemopoietic stem cells, G-CSF primed BM. Fortyfour patients who underwent BM harvesting after 6 days' administration of G-CSF, at a dose of 5 microg/kg per day, were compared with an equal number who underwent standard (unprimed) BM harvesting. We also analysed HR after autologous transplantation in 16 patients who received unprimed BM, 18 who received G-CSF-primed BM and 14 who received PBSC. RESULTS: G-CSF-primed BM was collected more quickly (p<0.00005) and yielded a larger number of cells (p<0.0001) than unprimed BM. Consequently, larger numbers of cells were available for administration following transplantation with G-CSF-primed BM. The results of HR after transplantation with G-CSF primed BM were intermediate between those of unprimed BM and PBSC. For example, platelet independence (unsupported platelet count > or = 20 2 10(9)/L) occurred after 22 days with unprimed BM, 14 days with G-CSF-printed BM and 10 days with PBSC (p for trend <0.0001) and the mean number of days when platelet transfusions were given was 10, 6 and 3 respectively (p for trend <0.005). These results reflected transplant cell doses. CONCLUSION: G-CSF-primed BM is a valuable source of hemopoietic stem cells for autologous transplantation and a useful alternative to PBSC to certain circumstances.