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Contamination of peripheral blood stem cell harvests by circulating
neuroblastoma cells
TJ Moss, DG Sanders, LC Lasky and B Bostrom
Ahmanson Pediatric Center, Cedars-Sinai Medical Center, Los Angeles, CA
90048.
Peripheral blood stem cells (PBSC) are being used as one alternative to
autologous marrow rescue for patients with neuroblastoma and other solid
malignancies. Some physicians prefer use of PBSC because less risk of tumor
contamination is believed to exist. This hypothesis was evaluated by
immunocytologic analysis of blood samples and concurrently drawn bone
marrow (BM) samples and of PBSC harvests obtained from 31 patients with
disseminated neuroblastoma. We found circulating neoplastic cells in 75% of
specimens analyzed at diagnosis, in 36% during therapy, and in 14% of PBSC
harvests. Tumor cells in blood obtained during therapy did not appear until
3 months after the time of diagnosis. Clearance of circulating
neuroblastoma cells was documented after two courses of induction
chemotherapy. Six of 13 patients with minimal or no BM disease had positive
blood specimens. We conclude that substantial risk of tumor contamination
of PB harvests exists and recommend that induction chemotherapy be
administered before hematopoietic progenitor cells are collected from
blood.
Volume 76,
Issue 9,
pp. 1879-1883,
11/01/1990
Copyright © 1990 by The American Society of Hematology
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