Transplantation of CD34+ peripheral blood progenitor cells after high- dose chemotherapy for patients with advanced multiple myeloma

Content Provider	Scilit
Author	Schiller, G. Vescio, R. Freytes, C. Spitzer, G. Sahebi, F. Lee, M. Wu, Ch Cao, J. Lee, Jc Hong, Ch
Copyright Year	1995
Description	A major potential problem of autologous transplantation in the treatment of advanced malignancy is the infusion of tumor cells. A multi-institutional study of purified CD34-selected peripheral blood progenitor cell (PBPC) transplantation was conducted in 37 patients with advanced multiple myeloma receiving myeloablative chemotherapy. Fourteen days after intermediate-dose cyclophosphamide, prednisone, and granulocyte colony-stimulating factor (G-CSF), a median of 3 (range, 2 to 5) 10-L leukaphereses yielded 9.8 x 10(8)/kg (range, 3.7 to 28.3) mononuclear cells. The adsorbed (column-bound) fraction contained 5.9 x 10(6) cells/kg (range, 1.6 to 25.5) with 4.65 x 10(6) CD34 cells/kg (range, 1.2 to 23.3). Using Poisson distribution analysis of positive polymerase chain reactions with patient-specific complementarity- determining region 1 (CDR1) and CDR3 Ig-gene primers, tumor was detected in leukapheresis products from 8 to 14 unselected patients and ranged from 1.13 x 10(4) to 2.14 x 10(6) malignant cells/kg. After CD34 selection, residual tumor was detected in only three patients' products. Overall, a greater than 2.7- to 4.5-log reduction in contaminating multiple myeloma cells was achieved. CD34 PBPCs were infused 1 day after busulfan (14 mg/kg) and cyclophosphamide (120 mg/kg), and granulocyte-macrophage colony-stimulating factor was used until hematologic recovery. The median time to both neutrophil and platelet recovery was 12 days (range, 11 to 16 days and 9 to 52 days, respectively). The median number of erythrocyte and platelet transfusions was 7 (range, 2 to 37) and 3 (range, 0 to 85), respectively. Patients receiving fewer than 2 x 10(6) CD34 cells/kg had significantly prolonged neutropenia, thrombocytopenia, and an increased red blood cell and platelet transfusion requirement. Thus, CD34 selection of PBPCs markedly reduces tumor contamination in multiple myeloma and provides effective hematopoietic support for patients receiving myeloablative therapy.
Related Links	https://ashpublications.org/blood/article-pdf/86/1/390/448755/390.pdf
Ending Page	397
Page Count	8
Starting Page	390
DOI	10.1182/blood.v86.1.390.bloodjournal861390
Journal	Blood
Issue Number	1
Volume Number	86
Language	English
Publisher	American Society of Hematology
Publisher Date	1995-07-01
Access Restriction	Open
Subject Keyword	Hematology Multiple Myeloma Platelet Transplantation Cd34 Selection Granulocyte Colony Stimulating Stimulating Factor Cd34 Cells/kg Journal: Blood (Vol- 8, Issue- 1)
Content Type	Text
Resource Type	Article