Hernández-Boluda Juan-Carlos, Carreras Enric, Cervantes Francisco, Marín Pedro, Arellano-Rodrigo Eduardo, Rovira Montserrat, Solé Francesc, Lloveras Elisabet, Espinet Blanca, Ocejo Agustín, Montserrat Emili
BMT Unit, Institute of Hematology and Oncology, Department of Hematology, Hospital del Mar, Villaroel 170, 08036 Barcelona, Spain.
Haematologica. 2002 Jan;87(1):17-22.
Autologous stem cell transplantation is a therapeutic option for chronic myeloid leukemia (CML) patients who are not candidates for allogeneic transplant. To reduce the risk of post-autografting disease recurrence, different strategies of stem cell selection have been attempted. The results of using recombinant human granulocyte colony-stimulating factor (rHuG-CSF) for harvesting hematopoietic progenitors in CML patients treated with interferon-a (IFN) are reported.
Twenty-one CML patients who received IFN for a median of 21 (8-68) months were mobilized with rHuG-CSF (10 mg/kg/day). Twelve were in complete (CCR) or major (MCR) cytogenetic response. Complete success was considered a sufficient harvest (> 1 x 10(6)/kg CD34(+) cells/kg) without Philadelphia (Ph)+ metaphases in at least one apheresis; a partial success was a sufficient harvest with 1-35% Ph(+) cells.
A total of 78 aphereses were performed. No patient had major side-effects. The median number (range) of mononuclear and CD34(+) cells obtained was, respectively, 8.6 x 10(8)/kg (0.9-22.6) and 3.3 x 10(6)/kg (0.4-26.3) per patient. A sufficient cell yield was collected in all but three patients. A complete/partial success was achieved in seven CCR/MCR patients (63%) and in three (33%) with other responses. Four patients underwent successful autografting using the stem cells obtained after rHuG-CSF mobilization.
Mobilization of IFN-treated patients using rHuG-CSF is safe and provides a significant proportion of Ph-negative progenitors in CML patients in complete or major cytogenetic response.
自体干细胞移植是不适合同基因移植的慢性髓性白血病（CML）患者的一种治疗选择。为降低自体移植后疾病复发风险，人们尝试了不同的干细胞选择策略。本文报道了使用重组人粒细胞集落刺激因子（rHuG-CSF）采集接受干扰素-α（IFN）治疗的CML患者造血祖细胞的结果。
21例接受IFN治疗中位时间为21（8 - 68）个月的CML患者，采用rHuG-CSF（10 mg/kg/天）进行动员。其中12例处于完全（CCR）或主要（MCR）细胞遗传学缓解状态。完全成功定义为至少一次单采中收获足够数量（> 1 x 10(6)/kg CD34(+)细胞/kg）且无费城（Ph）+中期分裂相；部分成功定义为收获足够数量且Ph(+)细胞占1 - 35%。
共进行了78次单采。无患者出现严重副作用。每位患者获得的单个核细胞和CD34(+)细胞的中位数（范围）分别为8.6 x 10(8)/kg（0.9 - 22.6）和3.3 x 10(6)/kg（0.4 - 26.3）。除3例患者外，其余患者均采集到足够的细胞产量。7例CCR/MCR患者（63%）和3例其他缓解状态患者（33%）获得了完全/部分成功。4例患者使用rHuG-CSF动员后获得的干细胞成功进行了自体移植。
使用rHuG-CSF动员接受IFN治疗的患者是安全的，并且能为处于完全或主要细胞遗传学缓解的CML患者提供相当比例的Ph阴性祖细胞。
