T cell-depleted granulocyte colony-stimulating factor (G-CSF) modified allogenic bone marrow transplantation for hematological malignancy improves graft CD34+ cell content but is associated with delayed pancytopenia.
Bone Marrow Transplant
; 21(5): 431-40, 1998 Mar.
Article
en En
| MEDLINE
| ID: mdl-9535034
ABSTRACT
To increase the stem cell content of T cell-depleted bone marrow transplants (BMT), we treated 12 patients with hematological malignancies with BMT from HLA-identical sibling donors given G-CSF 10 microg/kg/day for 5 days before marrow harvest. After CD34+ cell selection, patients received a median of 1.7 (range, 0.82-3.1) x 10(6) CD34+ cells/kg and 2.3 (range, 0.25-4.0) x 10(5) CD3+ cells/kg. All patients had initial engraftment but four developed pancytopenia between days 55-130 post-BMT. In two patients, this required a second infusion of G-CSF-mobilized donor peripheral blood progenitor cells. We observed no delayed pancytopenia in a matched historical group of 24 patients receiving T cell-depleted BMT without prior G-CSF stimulation. Compared to this control group, G-CSF-stimulated marrow recipients showed a significant decline in neutrophil and monocyte counts after 8 weeks. However, outcome after BMT was otherwise comparable, with a similar incidence of acute graft-versus-host disease and transplant-related mortality. Disease-free survival was 63 vs 67% for controls matched for CD34+ cell dose (P = NS). These results indicate that G-CSF stimulation can increase the CD34+ cell content of T cell-depleted marrow but carries a risk of late graft failure.
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Banco de datos:
MEDLINE
Asunto principal:
Pancitopenia
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Células Madre Hematopoyéticas
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Linfocitos T
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Factor Estimulante de Colonias de Granulocitos
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Trasplante de Médula Ósea
/
Antígenos CD34
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Neoplasias Hematológicas
/
Acondicionamiento Pretrasplante
Tipo de estudio:
Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Año:
1998
Tipo del documento:
Article