Collection of peripheral blood progenitor cells after the administration of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor

An analysis of 497 patients

C. H. Weaver, Lee Schwartzberg, R. Birch, F. A. Greco, S. Rhinehart, J. Hainsworth, T. Beeker, H. Price, L. Geier, J. Foster, J. West, B. Hazelton, C. D. Buckner

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: There is great interpatient variability in the number of peripheral blood stem cells collected, as measured by CD34+ cell content, after the administration of chemotherapy and a growth factor. The ability to predict patients who fail to yield adequate quantities of CD34+ cells would be of value. However, very few reports include large numbers of patients treated in an identical fashion. STUDY DESIGN AND METHODS: Between 1991 and 1995, 497 consecutive patients with a variety of malignant diseases received cyclophosphamide (4 g/m2), etoposide (600 mg/m2), and granulocyte-colony- stimulating factor (6 μg/kg/day) for mobilization and collection of a target dose ≤2.5 x 106 CD34+ cells per kg. Multivariate analyses were performed to determine the factors associated with failure to achieve this target harvest. RESULTS: A median of 14.71 x 106 CD34+ cells per kg (range, 0.08-137.55) was harvested with a median of 2 (range, 1-11) apheresis procedures. Ninety-one percent of patients yielded ≤2.5 x 106 CD34+ cells per kg. Patients with Stage II-III breast cancer, who had pretreatment platelet counts ≤150 x 109 per L and patients who underwent ≤1 prior chemotherapy regimen had improved CD34+ cell yields. However, most patients with adverse risk factors yielded ≤2.5 x 105 CD34+ cells per kg. CONCLUSION: A regimen of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor led to the successful collection of adequate numbers of CD34+ cells in most patients without excessive toxicity. These observations confirm previous reports that intense prior therapy adversely affects the quantity of CD34+ cells harvested. Pretreatment and posttreatment variables did not predict with any certainty the small fraction of patients who fail to yield ≤2.5 x 106 CD34+ cells per kg via multiple apheresis procedures.

Original languageEnglish (US)
Pages (from-to)896-903
Number of pages8
JournalTransfusion
Volume37
Issue number9
DOIs
StatePublished - Jan 1 1997

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Granulocyte Colony-Stimulating Factor
Etoposide
Cyclophosphamide
Statistical Factor Analysis
Blood Cells
Stem Cells
Blood Component Removal
Drug Therapy
Platelet Count
Intercellular Signaling Peptides and Proteins
Multivariate Analysis
Cell Count
Breast Neoplasms

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology
  • Hematology

Cite this

Collection of peripheral blood progenitor cells after the administration of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor : An analysis of 497 patients. / Weaver, C. H.; Schwartzberg, Lee; Birch, R.; Greco, F. A.; Rhinehart, S.; Hainsworth, J.; Beeker, T.; Price, H.; Geier, L.; Foster, J.; West, J.; Hazelton, B.; Buckner, C. D.

In: Transfusion, Vol. 37, No. 9, 01.01.1997, p. 896-903.

Research output: Contribution to journalArticle

Weaver, CH, Schwartzberg, L, Birch, R, Greco, FA, Rhinehart, S, Hainsworth, J, Beeker, T, Price, H, Geier, L, Foster, J, West, J, Hazelton, B & Buckner, CD 1997, 'Collection of peripheral blood progenitor cells after the administration of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor: An analysis of 497 patients', Transfusion, vol. 37, no. 9, pp. 896-903. https://doi.org/10.1046/j.1537-2995.1997.37997454014.x
Weaver, C. H. ; Schwartzberg, Lee ; Birch, R. ; Greco, F. A. ; Rhinehart, S. ; Hainsworth, J. ; Beeker, T. ; Price, H. ; Geier, L. ; Foster, J. ; West, J. ; Hazelton, B. ; Buckner, C. D. / Collection of peripheral blood progenitor cells after the administration of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor : An analysis of 497 patients. In: Transfusion. 1997 ; Vol. 37, No. 9. pp. 896-903.
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abstract = "BACKGROUND: There is great interpatient variability in the number of peripheral blood stem cells collected, as measured by CD34+ cell content, after the administration of chemotherapy and a growth factor. The ability to predict patients who fail to yield adequate quantities of CD34+ cells would be of value. However, very few reports include large numbers of patients treated in an identical fashion. STUDY DESIGN AND METHODS: Between 1991 and 1995, 497 consecutive patients with a variety of malignant diseases received cyclophosphamide (4 g/m2), etoposide (600 mg/m2), and granulocyte-colony- stimulating factor (6 μg/kg/day) for mobilization and collection of a target dose ≤2.5 x 106 CD34+ cells per kg. Multivariate analyses were performed to determine the factors associated with failure to achieve this target harvest. RESULTS: A median of 14.71 x 106 CD34+ cells per kg (range, 0.08-137.55) was harvested with a median of 2 (range, 1-11) apheresis procedures. Ninety-one percent of patients yielded ≤2.5 x 106 CD34+ cells per kg. Patients with Stage II-III breast cancer, who had pretreatment platelet counts ≤150 x 109 per L and patients who underwent ≤1 prior chemotherapy regimen had improved CD34+ cell yields. However, most patients with adverse risk factors yielded ≤2.5 x 105 CD34+ cells per kg. CONCLUSION: A regimen of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor led to the successful collection of adequate numbers of CD34+ cells in most patients without excessive toxicity. These observations confirm previous reports that intense prior therapy adversely affects the quantity of CD34+ cells harvested. Pretreatment and posttreatment variables did not predict with any certainty the small fraction of patients who fail to yield ≤2.5 x 106 CD34+ cells per kg via multiple apheresis procedures.",
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T1 - Collection of peripheral blood progenitor cells after the administration of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor

T2 - An analysis of 497 patients

AU - Weaver, C. H.

AU - Schwartzberg, Lee

AU - Birch, R.

AU - Greco, F. A.

AU - Rhinehart, S.

AU - Hainsworth, J.

AU - Beeker, T.

AU - Price, H.

AU - Geier, L.

AU - Foster, J.

AU - West, J.

AU - Hazelton, B.

AU - Buckner, C. D.

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N2 - BACKGROUND: There is great interpatient variability in the number of peripheral blood stem cells collected, as measured by CD34+ cell content, after the administration of chemotherapy and a growth factor. The ability to predict patients who fail to yield adequate quantities of CD34+ cells would be of value. However, very few reports include large numbers of patients treated in an identical fashion. STUDY DESIGN AND METHODS: Between 1991 and 1995, 497 consecutive patients with a variety of malignant diseases received cyclophosphamide (4 g/m2), etoposide (600 mg/m2), and granulocyte-colony- stimulating factor (6 μg/kg/day) for mobilization and collection of a target dose ≤2.5 x 106 CD34+ cells per kg. Multivariate analyses were performed to determine the factors associated with failure to achieve this target harvest. RESULTS: A median of 14.71 x 106 CD34+ cells per kg (range, 0.08-137.55) was harvested with a median of 2 (range, 1-11) apheresis procedures. Ninety-one percent of patients yielded ≤2.5 x 106 CD34+ cells per kg. Patients with Stage II-III breast cancer, who had pretreatment platelet counts ≤150 x 109 per L and patients who underwent ≤1 prior chemotherapy regimen had improved CD34+ cell yields. However, most patients with adverse risk factors yielded ≤2.5 x 105 CD34+ cells per kg. CONCLUSION: A regimen of cyclophosphamide, etoposide, and granulocyte-colony-stimulating factor led to the successful collection of adequate numbers of CD34+ cells in most patients without excessive toxicity. These observations confirm previous reports that intense prior therapy adversely affects the quantity of CD34+ cells harvested. Pretreatment and posttreatment variables did not predict with any certainty the small fraction of patients who fail to yield ≤2.5 x 106 CD34+ cells per kg via multiple apheresis procedures.

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