RESUMO
We report our single institution's effort to standardize the method of collecting peripheral blood progenitor cells (PBPC) used for autologous transplantation. PBPC were mobilized by different types of chemotherapy followed by G-CSF (24 patients) or G-CSF alone (six patients) in 30 patients with various underlying neoplastic diseases. A median of three aphereses (range: 2-7), using the CS3000 cell separator was performed and a blood volume of 101 was processed. We studied the relationship between the absolute numbers of circulating leukocytes, mononuclear cells and CD34+ cells and the amount of PBPC collected during a single apheresis procedure. CD34+ cells were quantified by leukocyte subset analysis based on flow cytometry. Both CFU-GM and CD34+ cell contents of the apheresis products (69 procedures analyzed) correlated strongly: rho = 0.936, P = 0.0001). Regression analysis showed that the total number of CD34+ cells or CFU-GM content of the apheresis products could be predicted (r = 0.915, P = 0.0001) from the absolute number of CD34+ cells in the blood. A number of 10 circulating CD34+ cells per mm3 blood ensured a minimum of 0.5 x 10(6) CD34+ cells per kg, collected on the same day. Of the 30 patients, 17 received an autologous graft that contained only PBPC in 13. Long-term and complete hematological reconstitution was observed in all patients who had a minimum of 2 x 10(6) CD34+ cells per kg reinfused.
Assuntos
Antígenos CD34/análise , Contagem de Células Sanguíneas , Remoção de Componentes Sanguíneos/métodos , Células-Tronco Hematopoéticas , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Remoção de Componentes Sanguíneos/estatística & dados numéricos , Medula Óssea/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Ensaio de Unidades Formadoras de Colônias , Ciclofosfamida/farmacologia , Feminino , Citometria de Fluxo , Fator Estimulador de Colônias de Granulócitos/farmacologia , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas/efeitos dos fármacos , Humanos , Masculino , Melfalan/farmacologia , Pessoa de Meia-Idade , Neoplasias/sangue , Neoplasias/terapia , Fatores de Tempo , Condicionamento Pré-Transplante/métodosRESUMO
The choice of chemotherapy for advanced breast cancer patients is based on both response rates and anticipated side effects. Two polychemotherapy regimens, ACV and NCV, were compared in an open study with 90 patients of whom 69 were evaluable both for efficacy and toxicity. Both ACV and NCV are active in metastatic breast cancer. ACV leads to more remissions in a relatively short time. NCV treatment results in a larger proportion of stable diseases. ACV causes more important alopecia, nausea and vomiting. NCV gives more anemia. The characteristics of both treatment results give the oncologist the opportunity to choose in particular clinical situations.