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
Date
2003
Authors
To, L.
Bashford, J.
Durrant, S.
MacMillan, J.
Schwarer, A.
Prince, H.
Gibson, J.
Lewis, I.
Swart, B.
Marty, J.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
Bone Marrow Transplantation, 2003; 31(5):371-378
Statement of Responsibility
Conference Name
Abstract
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 times 106/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 mug/kg was started 3 days before filgrastim and continued for the duration of filgrastim. In the chemotherapy-plus-filgrastim group (n=31), rHuSCF 20 mug/kg/day plus filgrastim 5–10 mug/kg/day were administered concurrently. Leukaphereses were continued to a maximum of four procedures or a target of greater than or equal to3 times 106 CD34+ cells/kg. In both groups, CD34+ yield (times 106/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 times 106/kg. The probability of a successful mobilization was the same in those with a CD34+ yield of 0.5–0.75 times 106/kg BW in the prior mobilization as in those with 0.76–1.99 times 106/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.