Document Detail


High dose therapy and autologous bone marrow versus blood cell rescue. South Island Bone Marrow Transplant Unit.
MedLine Citation:
PMID:  8598936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To compare haematological recovery and supportive care requirements for patients receiving high dose therapy (HDT) supported by rescue with either autologous cytokine mobilised blood cells (BC) or autologous bone marrow (BM). To identify stem cell harvest criteria predictive of rapid haematological recovery after rescue with BC. METHODS: Single arm, open study in four groups of 69 consecutive patients undergoing HDT in a single institution from 1986-95. Group 1 contained patients with solid tumours or myeloma rescued with BC alone (n = 14); group 2 patients with solid tumours rescued with BM (n = 31); group 3 patients with acute leukaemia rescued with BM (n = 21); and group 4 patients with solid tumours rescued with both BC and BM (n = 3). RESULTS: Haemopoietic recovery was most rapid for group 1 where, in comparison with the BM group transplanted for similar disease (group 2), highly significant reductions were observed for median days to 1) neutrophil s >/= 0.5 x 10(9)L (12 v 22; p 0.0001); 2) neutrophils >/= 1.0 x 10(9)/L (14 v 27 ; p = 0.0001); platelets >/= 20 x 10(9) /L (11 v 20; p = 0.0005); and 4) platelets >/= 50 x 10(9)/L (15 v 27; p = 0.001). Similar significant reductions for the BC group over group 2 were also observed for median, (1) inpatient days (22 v 30; p = 0.0001); (2) red cell transfusions (2 v 5; p = 0.01) ; (3) platelet transfusions (2 v 6; p = 0.0001); (4) days of fever (2 v 8; p = 0.001); and (5) days on IV antibiotics (8 v 14; p = 0.02). Group 3 patients yielded data either similar to or less advantageous to that in group 2 and group 4 patients yielded data intermediate between groups 1 and 2. Data from BC harvests suggested that yields of CD34+ cells of > 2.0 x 10(6)/kg and/or of colony forming units-granulocyte-macrophage (CFU-GM) of > 6.0 x 10(4)/kg were predictive of rapid haemopoietic recovery. CONCLUSION: For haemopoietic rescue following single HDT for solid tumours BC has considerable advantages over BM.
Authors:
G R Hill; A Inder; W N Patton; D N Hart
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  The New Zealand medical journal     Volume:  109     ISSN:  0028-8446     ISO Abbreviation:  N. Z. Med. J.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-04-25     Completed Date:  1996-04-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401067     Medline TA:  N Z Med J     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  45-8     Citation Subset:  IM    
Affiliation:
Christchurch Hospital, Christchurch.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antigens, CD34 / blood
Antineoplastic Combined Chemotherapy Protocols / adverse effects*
Blood Cell Count
Bone Marrow Transplantation / methods*
Child
Child, Preschool
Granulocyte Colony-Stimulating Factor / therapeutic use*
Granulocyte-Macrophage Colony-Stimulating Factor / blood
Hematopoiesis / drug effects,  radiation effects
Hematopoietic Stem Cell Transplantation / methods*
Humans
Length of Stay
Middle Aged
Neoplasms / blood,  therapy*
Predictive Value of Tests
Radiotherapy, High-Energy / adverse effects*
Transplantation, Autologous / methods
Chemical
Reg. No./Substance:
0/Antigens, CD34; 143011-72-7/Granulocyte Colony-Stimulating Factor; 83869-56-1/Granulocyte-Macrophage Colony-Stimulating Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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