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Blood, 1 November 2000, Vol. 96, No. 9, pp. 3001-3007
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Ex vivo expanded peripheral blood progenitor cells provide rapid
neutrophil recovery after high-dose chemotherapy in patients with
breast cancer
Ian McNiece,
Roy Jones,
Scott I. Bearman,
Pablo Cagnoni,
Yago Nieto,
Wilbur Franklin,
John Ryder,
Andrea Steele,
Judy Stoltz,
Peggy Russell,
Janet McDermitt,
Christopher Hogan,
James Murphy, and
Elizabeth J. Shpall
From the BMT Program, University of Colorado Health
Sciences Center, Denver, CO.
Ex vivo expanded peripheral blood progenitor cells (PBPCs) have
been proposed as a source of hematopoietic support to decrease or
eliminate the period of neutropenia after high-dose chemotherapy. CD34
cells were selected from rhG-CSF mobilized PBPCs from patients with
breast cancer and were cultured for 10 days in defined media containing
100 ng/mL each of rhSCF, rhG-CSF, and PEG-rhMGDF in 1 L Teflon bags at
20 000 cells/mL. After culture the cells were washed and reinfused on
day 0 of transplantation. On day +1, cohort 1 patients (n = 10) also
received an unexpanded CD34-selected PBPC product. These patients
engrafted neutrophils (absolute neutrophil count, >500/µL) in a
median of 6 (range, 5-14) days. Cohort 2 patients (n = 11), who
received expanded PBPCs only, engrafted neutrophils in a median of 8 (range, 4-16) days. In comparison, the median time to neutrophil
engraftment in a historical control group of patients (n = 100) was 9 days (range, 7-30 days). All surviving patients are now past the
15-month posttransplantation stage with no evidence of late graft
failure. The total number of nucleated cells harvested after expansion
culture was shown to be the best predictor of time to neutrophil
engraftment, with all patients receiving more than
4 × 107 cells/kg, engrafting neutrophils by day 8. No
significant effect on platelet recovery was observed in any patient.
These data demonstrate that PBPCs expanded under the conditions defined
can shorten the time to engraftment of neutrophils compared with
historical controls and that the rate of engraftment is related to the
dose of expanded cells transplanted.
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