Document Detail


Successful autologous bone marrow rescue in patients who failed peripheral blood stem cell mobilization.
MedLine Citation:
PMID:  11195005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We assessed autologous bone marrow (BM) harvest and hematologic recovery after high-dose chemotherapy (HDCT) in patients who failed to achieve peripheral blood stem cell (PBSC) mobilization. One hundred and ninety-three patients with germ cell tumor, malignant lymphoma, sarcoma or medulloblastoma were scheduled for HDCT. In 123 patients, PBSC were mobilized by disease-specific chemotherapy plus granulocyte colony-stimulating factor (G-CSF). In 110/ 123 patients (89%) with circulating CD34+ cell counts 2 > or = 10/microl, sufficient hematopoietic autografts were collected (group A). In 13/123 patients (11%) with peripheral CD34 + cell counts < 10/microl, PBSC harvesting was not performed (group B). These latter patients were classified as "poor mobilizers" and underwent second-line BM harvest at a median of 46 (range 10-99) days after mobilization failure. Seventy patients with first-line BM harvest (group C) acted as historical controls. Ten patients from group B proceeded to HDCT and nine were evaluable for hematopoietic reconstitution. Recovery to neutrophils >0.5 x 10(9)/l was comparable with group C patients: 16 (range 9-34) days vs 13 (range 8-98) days. However, platelet (PLT) reconstitution >20 x 10(9)/l was significantly slower, with a median of 35 (range 13-50) days as compared with 19 (range 9-148) days (P = 0.0106) for control patients. Supportive care requirements, febrile days and length of hospital stay were not significantly different between the two groups of patients. We conclude that patients who fail to mobilize PBSC should be evaluated for second-line BM harvest. This approach may preserve the therapeutic option of HDCT for these patients.
Authors:
O Rick; J Beyer; D Kingreen; J S Kühl; J Zingsem; D Huhn; W Siegert; N Schwella
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Annals of hematology     Volume:  79     ISSN:  0939-5555     ISO Abbreviation:  Ann. Hematol.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-01-18     Completed Date:  2001-01-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9107334     Medline TA:  Ann Hematol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  681-6     Citation Subset:  IM    
Affiliation:
Klinik für Innere Medizin mS Hämatologie/Onkologie, Charité, Humboldt-Universität, Berlin, Germany. oliver.rick@charite.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antineoplastic Agents / administration & dosage
Bone Marrow Transplantation*
Child
Dose-Response Relationship, Drug
Female
Hematologic Neoplasms / therapy
Hematopoietic Stem Cell Mobilization*
Hematopoietic Stem Cell Transplantation*
Humans
Male
Middle Aged
Retrospective Studies
Tissue and Organ Harvesting
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

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