Peripheral Blood Stem Cells Mobilization with G-CSF (FILGRASTIM) Alone for Autologous Transplant in Myeloid and Lymphoid Malignancies

Abstract

In order to determine whether granulocyte colony-stimulating factor (G-CSF) alone was capable of mobilizing peripheral blood stem cells (PBSC) in myeloid as well in lymphoid malignancies, G-CSF (filgrastim), 5 μg/kg/day, SC, was administered to 48 patients with myeloid or lymphoid malignancies at various stages, after hematopoietic recovery from last chemotherapy. PBSC were harvested using daily aphereses from day 5 of G-CSF therapy. An adequate PBSC graft could be harvested in 43 patients (90%) after 2 to 5 (median 3) aphereses. Predictive factors for a good PBSC yield in a multivariate analysis included a high WBC count on day 5 of G-CSF therapy, and a diagnosis of myeloid malignancy. Thirty patients were transplanted after various conditioning regimens. Median times to neutrophil > 0.5 x 10⁹/1 and platelet > 50 x 10⁹/1 were 15 and 32 days respectively. The harvest of > 10 x 10⁴ CFU-GM/kg and the absence of busulfan in the conditioning regimen were predictive of early platelet recovery. We conclude that G-CSF therapy initiated during stable hematopoiesis is efficient to allow PBSC harvest for autografting in myeloid as well as lymphoid malignancies.