Serum G-CSF levels in patients undergoing G-CSF/chemotherapy mobilized peripheral stem cell harvest and predictors of neutrophil and platelet recovery.

Granulocyte colony-stimulating factor (G-CSF)/Chemotherapy mobilized peripheral blood progenitors are an effective source of stem cells which affords rapid and complete hematopoietic engraftment after myeloablative chemotherapy regimens. The dose of G-CSF most commonly used for mobilization is 5 micrograms/kg. We measured G-CSF levels in patients with chemosensitive malignancies undergoing peripheral stem cell harvest to determine whether there was a relationship between serum G-CSF levels and the yield of CD34+ hematopoietic progenitors. Peripheral blood stem cells (PBSCs) were mobilized by chemotherapy followed by G-CSF (5 micrograms/kg) started 24 hours after completion of chemotherapy. PBSCs were collected by daily leukapheresis during G-CSF stimulation once the WBC had recovered to 1.0 x 10(9)/L, with 10 liters of blood processed using a Fenwall CS 3000. G-CSF levels were monitored daily before and after leukapheresis. CD34+ cells from daily leukapheresis collections were determined in 11 patients. Immunophenotyping analyses of CD34+ and non-CD34+ cells for surface antigens CD38+, HLA-DR, CD71+, CD61+ and CD42a+ were performed on these daily leukapheresis. The mean (SD) number of days to neutrophil recovery (NR: > or = 0.5 x 10(9)/L) after stem cell reinfusion was 9.2 (1.92). The corresponding values for platelet recovery (PR: > or = 20 x 10(9) L) were 8.1 (2.39) days. Using multiple regression analyses, the best predictors for NR were: last G-CSF (R2 = 0.21); last G-CSF and CD34+ (R2 = 0.67); last G-CSF, CD34+ and number of chemotherapy cycles (R2 = 0.72).(ABSTRACT TRUNCATED AT 250 WORDS)