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(AU)

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.

Evaluación de la movilización de células progenitoras hematopoyéticas con Filgen JP (Filgrastim Clausen)* para trasplante autólogo en hemopatías malignas y tumores sólidos. Experiencias de un centro (Hospital Maciel, Montevideo, Uruguay)

La estimulación con filgrastim es un método válido de movilización de células CD34+ para trasplante de progenitores hematopoyéticos (TPH). Obtener una celularidad adecuada depende, entre otros factores, del agente movilizador y su dosis. Se analizó la experiencia del Servicio de Hematología del Hospital Maciel en la movilización de progenitores hematopoyéticos con Filgen (Filgrastim Clausen). Entre enero 2002 y abril 2006 se realizaron 100 movilizaciones: 81 para TPH autólogo y 19 para TPH alogénico. Para TPH autólogo, se utilizó una dosis total media de filgrastim de 78 mcg/kg registrándose una media de 43.9 células CD34+/mm3 en sangre periférica al quinto día de estimulación. Con un promedio de 2,3 aféresis, se obtuvieron 4,7 x 10 6 células CD34+/kg promedio. Mediante técnica de cluster analysis surgen tres grupos diferenciados por: dosis de filgrastim, células CD34+ en sangre periférica, edad y número de aféresis. No hubo efectos adversos que determinaran suspensión del fármaco

El paciente anémico / The anemic patient

El paciente anémico representa un conjunto polimorfo de nosologías no relacionadas en las que están incluidas un amplio espectro de hemopatías y de enfermedades generales. El análisis minucioso de la história clínica permite catalogar la jerarquía del síndrome funcional anémico, el ritmo evolutivo de la enfermedad, la coparticipación del sector blanco y plaquetario, así como presumir la etiología y los mecanismos patogénicos. El hemograma cuantifica, orienta y puede constituir el nivel diagnóstico, por lo cual debe formar parte de la historia, ya que su paralelismo con la clinica y de su calificada y completa realización dependen todos los exámenes complementarios posteriores que darán precisión y consistencia científica al diagnóstico clínico presuntivo. En todos los casos es necesario pasar por estas antes de abordar los problemas terapéuticos de fondo, ya que un diagnóstico certero se amolda con una terapéutica correcta y en consecuencia, la relación beneficio/riesgo que implica cualquier tratamiento, estará volcada a la obtención del máximo rendimiento y bienestar para el enfermo

Prueba de resistencia al calor: un test sencillo que permitió el diagnóstico de hemoglobinuria paroxística nocturna / Heat resistance test: A simple test enabling the diagnosis of nocturnal parosysmal hemoglobinuria

Se presentó el estudio de laboratorio de uno de los primeros casos de Hemoglobinuria Paroxística Nocturna (HPN) diagnosticados en Uruguay. Por lo complejo del cuadro clínico y su expresividad proteiforme, esta rara enfermedad de muy baja frecuencia, 2 x 10**6 de habitantes, sigue siendo de diagnóstico difícil. En nuestro caso, el diagnóstico fue facilitado por una prueba de la resistencia al calor, y la realización posterior de las pruebas clásicas: test de Ham y test de hemólisis de la sacarosa. Dadas las circunstancias que condujeron al diagnóstico, se analizaron distintos aspectos interpretativos que surgieron durante la etapa analítica