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A Bacigalupo, G Piaggio, M Podesta, MT Van Lint, M Valbonesi, G Lercari, PG Mori, M Pasino, E Franchini and L Rivabella
Divisione di Ematologia, Ospedale San Martino, Genova, Italy.
The aim of this study was to test whether prolonged administration of
granulocyte colony-stimulating factor (G-CSF) would allow the collection by
leukapheresis of PBHP in patients with SAA. For this purpose, nine SAA
patients, 7 to 46 years old, six of whom were enrolled at diagnosis of
their disease and three after previous immunosuppression had failed, were
treated with antilymphocyte globulin (ALG) (day 1 to 5), cyclosporin A (5
mg/kg/d orally) (day 6 to 90) and G-CSF 5 micrograms/kg/d (day 6 to 90). A
total of 40 leukaphereses were performed, (range 2 to 7 per patient),
between days +10 and +168 from G- CSF treatment. White blood cell count at
the time of harvest ranged from 1.2 to 18.1 x 10(9)/L. Results can be
summarized as follows: the median number of cells collected per patient was
5.0 x 10(8)/kg (range 2.6 to 18.7), the median number of CD34+ cells was
1.8 x 10(6)/kg (range 0.27 to 3.8) and the median number of colony-forming
units granulocyte-macrophage (CFU-GM) was 3.9 x 10(4)/kg (range 0 to 39).
Twenty leukaphereses performed between days +33 and +77 of G-CSF treatment
grew granulocyte macrophages and erythroid colonies in vitro. No colony
growth was obtained from 20 leukaphereses performed before day +33 or after
day +80. In six patients the total number of CFU-GM recovered were in the
range described for autologous peripheral blood stem cell grafts. (2.6 to
39 x 10(4)/kg). In conclusion, this study suggests that circulating
hematopoietic progenitors can be recovered after ALG priming and after at
least 1 month of G-CSF treatment in a proportion of patients with SAA.
Whether these cells will be suitable for autologous transplantation remains
to be determined.
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| Copyright © 1993 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||