A combination of low-dose cyclophosphamide and colony-stimulating factors is more cost-effective than granulocyte-colony-stimulating factors alone in mobilizing peripheral blood stem and progenitor cells

Transfusion
B MeisenbergR McMillan

Abstract

The use of peripheral blood progenitor cells (PBPCs) instead of autologous bone marrow leads to more rapid engraftment following high-dose chemotherapy. Mobilization regimens differ with respect to toxicity, efficiency, and cost. Two cohorts of patients with breast cancer received one of two mobilization regimens: granulocyte-colony-stimulating factor (G-CSF) at 10 micrograms per kg was given subcutaneously for 5 days, with leukapheresis begun on Day 6, or low-dose cyclophosphamide followed by sequential granulocyte-macrophage-CSF (GM-CSF) at 5 micrograms per kg for 5 days and by G-CSF at 10 micrograms per kg, with leukapheresis begun on Day 11. Results of CD34+ cell collection, engraftment, and costs of mobilization were determined. The combination chemotherapy and growth factor regimen was more efficient in mobilizing CD34+ cells. Sixty-six percent of patients reached a target 4 x 10(6) CD34+ cells per kg in a single leukapheresis session with the combination regimen, compared to 14 percent who received G-CSF alone (p < 0.01). The mean number of leukapheresis sessions required to reach a target of 4 x 10(6) CD34+ cells per kg was 1.3 for the combination regimen and 2.7 for the regimen of G-CSF alone (p < 0.01). One patient in...Continue Reading

Citations

May 23, 2012·Pathology International·Iwao Emura, Hiroyuki Usuda
Jan 27, 2016·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Ilhami BerberMustafa Ozgul
Feb 24, 2009·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Fernando CalleraCláudio M T P de Melo
Sep 27, 2003·British Journal of Haematology·Antonio PagliucaUNKNOWN Haemato-Oncology Task Force of the British Committee for Standards in Haematology
Aug 30, 2005·Blood Reviews·Michele Cottler-Fox, Tsvee Lapidot
Nov 25, 2003·Hematology·Michele H Cottler-FoxSteven Devine
Oct 14, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·H OzerUNKNOWN American Society of Clinical Oncology

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