Mobilization of hematopoietic progenitor cells with granulocyte colony stimulating factors for autologous transplant in hematologic malignancies: a single center experience

BACKGROUND: In 2006 the Hematology Service of Hospital Maciel published its experience with peripheral blood progenitor cell harvesting for autologous stem cell transplantation using Filgen JP (Clausen Filgrastim). After mobilization with a mean filgrastim dose of 78 mcg/Kg, 4.7 x 10(6) CD34+ cells/Kg were obtained by apheresis. Age above 50, multiple myeloma as underlying disease and a malignancy that was not in remission were identified as frequent characteristics among patients showing complex mobilization. OBJECTIVE: The aim of this study was to compare stem cell mobilization using different brands of filgrastim. METHODS: One hundred and fifty-seven mobilizations performed between 1997 and 2006 were analyzed. This retrospective analysis comparative two groups of patients: those mobilized with different brands of filgrastim (Group A) and those who received Filgen JP (Clausen Filgrastim) as mobilizing agent (Group B). A cluster analysis technique was used to identify four clusters of individuals with different behaviors differentiated by age, total dose of filgrastim required, number of apheresis and harvested CD34+ cells. RESULTS: The mean total dose of filgrastim administered was 105 mcg/Kg, the median number of apheresis was 2 procedures and the mean number of harvested stem cells was 4.98 x 10(6) CD34+ cells/Kg. No significant differences were observed between Groups A and B regarding the number of apheresis, harvested CD34+ cells and number of mobilization failures, however the total dose of filgrastim was significantly lower in Group B. CONCLUSIONS: Among other factors, the origin of the cytokine used as mobilizing agent is an element to be considered when evaluating CD34+ cell mobilization results.

Mobilization of hematopoietic progenitor cells with granulocyte colony stimulating factors for autologous transplant in hematologic malignancies: a single center experience.

BACKGROUND: In 2006 the Hematology Service of Hospital Maciel published its experience with peripheral blood progenitor cell harvesting for autologous stem cell transplantation using Filgen JP (Clausen Filgrastim). After mobilization with a mean filgrastim dose of 78 mcg/Kg, 4.7 x 10(6) CD34(+) cells/Kg were obtained by apheresis. Age above 50, multiple myeloma as underlying disease and a malignancy that was not in remission were identified as frequent characteristics among patients showing complex mobilization. OBJECTIVE: The aim of this study was to compare stem cell mobilization using different brands of filgrastim. METHODS: One hundred and fifty-seven mobilizations performed between 1997 and 2006 were analyzed. This retrospective analysis comparative two groups of patients: those mobilized with different brands of filgrastim (Group A) and those who received Filgen JP (Clausen Filgrastim) as mobilizing agent (Group B). A cluster analysis technique was used to identify four clusters of individuals with different behaviors differentiated by age, total dose of filgrastim required, number of apheresis and harvested CD34(+) cells. RESULTS: The mean total dose of filgrastim administered was 105 mcg/Kg, the median number of apheresis was 2 procedures and the mean number of harvested stem cells was 4.98 x 10(6) CD34(+) cells/Kg. No significant differences were observed between Groups A and B regarding the number of apheresis, harvested CD34(+) cells and number of mobilization failures, however the total dose of filgrastim was significantly lower in Group B. CONCLUSIONS: Among other factors, the origin of the cytokine used as mobilizing agent is an element to be considered when evaluating CD34(+) cell mobilization results.

Platelet recovery and transfusion needs after reduced intensity conditioning allogeneic peripheral blood stem cell transplantation.

OBJECTIVE: The aim of this retrospective study was to assess platelet transfusion needs and the kinetics and predictive factors for platelet recovery after reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (HSCT). MATERIALS AND METHODS: The profile of platelet recovery and transfusion needs in the first 100 days after RIC allo-SCT from a human leukocyte antigen-identical sibling donor was analyzed in a single-center series of 166 consecutive patients. RESULTS: Platelet recovery (>20g/L) was observed at a median of 9 days (range, 0-99 days) after allo-SCT. One-hundred forty-five patients could be assessed for platelet recovery at day +100, of which 99 (68%) had a platelet count >99g/L. In the multivariate analysis, a lower platelet counts before the start of conditioning, and occurrence of grade III to IV acute graft-vs-host disease significantly influenced day-100 platelet recovery >100 x 10(9)/L (odds ratio [OR] = 2.51; 95% confidence interval [CI], 1.13-5.61; p = 0.025; and OR = 7.6; 95% CI, 3.0-19.29; p = 0.00002, respectively). Eighty-three patients (50%) did not require any platelet transfusion during follow-up. Multivariate analysis found the following parameters to be significantly associated with platelet transfusion needs: conditioning regimen type (use of antithymoglobulin: OR = 3.96; 95% CI, 1.77-8.89; p = 0.008), platelet count prior to RIC administration (>144g/L; OR = 0.18; 95% CI, 0.08-0.39; p = 0.00001) and occurrence of grade III to IV acute GVHD (OR = 11.62; 95% CI, 4.01-33.66; p = 0.000006). CONCLUSIONS: Overall, these observations show a lower rate of platelet transfusion and faster platelet recovery kinetics after RIC HSCT, but also highlight the negative effect of severe acute GVHD as a risk factor for increased need for platelet transfusions.