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Type: Journal article
Title: CD34+ selection of autologous peripheral blood stem cells for transplantation following sequential cycles of high-dose therapy and mobilisation in multiple myeloma
Author: Dyson, P.
Horvath, N.
Joshua, D.
Barrow, L.
Van Holst, N.
Brown, R.
Gibson, J.
To, L.
Citation: Bone Marrow Transplantation, 2000; 25(11):1175-1184
Publisher: Nature Publishing Group
Issue Date: 2000
ISSN: 0268-3369
Statement of
P G Dyson, N Horvath, D Joshua, L Barrow, N G Van Holst, R Brown, J Gibson and L B To
Abstract: A potential problem of autologous transplantation in the treatment of multiple myeloma (MM) is the infusion of tumor cells. CD34+ selection has been used to purge autografts in MM and it is also possible to reduce tumour cell contamination of autografts by cytotoxic drug therapy prior to peripheral blood stem cell (PBSC) collection. To evaluate the effectiveness of a protocol combining multiple cycles of high-dose therapy and CD34+ selection to reduce tumour contamination of PBSC autografts, 34 MM patients were entered on a treatment schedule comprising two sequential cycles of mobilisation, CD34+ selection, and transplantation following high-dose therapy. In the second cycle of mobilisation there was a five-fold reduction in tumour contamination of the stem cell harvest (0.5 x 106/kg) compared with the first cycle (2.5 x 106/kg). In the 97 CD34+ selection procedures performed a median of 185 x 108 mononuclear cells (MNC) were processed yielding a median of 0.98 x 108 CD34+-enriched cells. CD34+ cells were enriched 68-fold from 1. 3% to 88.6%. The median yield of CD34+ cells was 42.2%. Following CD34+ selection the tumour cell contamination of the leukapheresis product was reduced by a median of 2.7 logs. This study demonstrates that in multiple myeloma a significant reduction in the malignant contamination of stem cell autografts can be achieved by combining the in vivo purging effect of cytotoxic therapy with in vitro purging by CD34+ selection.
Keywords: Humans
Multiple Myeloma
Granulocyte-Macrophage Colony-Stimulating Factor
Recombinant Proteins
Antineoplastic Combined Chemotherapy Protocols
Antigens, CD34
Hematopoietic Stem Cell Mobilization
Combined Modality Therapy
Hematopoietic Stem Cell Transplantation
Transplantation, Autologous
Regression Analysis
Middle Aged
Rights: Copyright © 2000 Nature Publishing Group
DOI: 10.1038/sj.bmt.1702408
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