Document Detail


Successful mobilization of peripheral blood stem cells after addition of ancestim (stem cell factor) in patients who had failed a prior mobilization with filgrastim (granulocyte colony-stimulating factor) alone or with chemotherapy plus filgrastim.
MedLine Citation:
PMID:  12634728     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study assessed the ability of recombinant human stem cell factor (rHuSCF) to mobilize stem cells in 44 patients who had failed a prior mobilization (CD34(+) yield 0.5-1.9 x 10(6)/kg BW) with filgrastim-alone or chemotherapy-plus-filgrastim. The same mobilization regimen was used with the addition of rHuSCF. In the filgrastim-alone group (n=13), rHuSCF 20 microg/kg was started 3 days before filgrastim and continued for the duration of filgrastim. In the chemotherapy-plus-filgrastim group (n=31), rHuSCF 20 microg/kg/day plus filgrastim 5-10 microg/kg/day were administered concurrently. Leukaphereses were continued to a maximum of four procedures or a target of >or=3 x 10(6) CD34(+) cells/kg. In both groups, CD34(+) yield (x 10(6)/kg BW) of the study mobilization was higher than that of the prior mobilization (median: 2.42 vs 0.84 P=0.002 and 1.64 vs 0.99 P=<0.001, respectively). In all 54 and 45% of patients in the filgrastim-alone group and chemotherapy-plus-filgrastim group, respectively, reached the threshold yield of 2 x 10(6)/kg. The probability of a successful mobilization was the same in those with a CD34+ yield of 0.5-0.75 x 10(6)/kg BW in the prior mobilization as in those with 0.76-1.99 x 10(6)/kg BW. Downmodulation of c-kit expression and a lower percentage of Thy-1 positivity in the mobilized CD34(+) cells were noted in the successful mobilizers compared with those in the poor mobilizers. This study shows that rhuSCF is effective in approximately half the patients who had failed a prior mobilization and allows them to proceed to transplant. It also points to the likely role of the SCF/c-kit ligand pair in mobilization.
Authors:
L B To; J Bashford; S Durrant; J MacMillan; A P Schwarer; H M Prince; J Gibson; I Lewis; B Swart; J Marty; T Rawling; L Ashman; S Charles; B Cohen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  31     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-13     Completed Date:  2003-10-09     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  371-8     Citation Subset:  IM    
Affiliation:
Division of Haematology, Hanson Centre for Cancer Research, Adelaide, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antigens, CD34 / analysis
Female
Filgrastim / pharmacology*
Hematopoietic Stem Cell Mobilization*
Humans
Male
Middle Aged
Peripheral Blood Stem Cell Transplantation
Proto-Oncogene Proteins c-kit / analysis
Recombinant Proteins / pharmacology
Stem Cell Factor / pharmacology*
Chemical
Reg. No./Substance:
0/Antigens, CD34; 0/Recombinant Proteins; 0/Stem Cell Factor; 121181-53-1/Filgrastim; EC 2.7.10.1/Proto-Oncogene Proteins c-kit

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