Allogenic transplants with peripheral blood progenitor cells: a report of six cases

Leuk Lymphoma. 1996 Feb;20(5-6):471-4. doi: 10.3109/10428199609052431.

Abstract

Six patients with high-risk leukaemia received a myeloablative regimen followed by allogeneic peripheral blood progenitor cells transplantation (PBPCT) from an HLA-identical sibling donor. Donors received 10-12 mu g/kg/day of G-CSF subcutaneously for 5 days. G-CSF was well tolerated except for moderate bone pain. Peripheral blood leukapheresis product contained 1-4 times more CD34+ cells and approximately a log more of T lymphocytes than marrow grafts from normal donors. In the two first cases the leukapheresis product was partially depleted of T-lymphocytes using counterflow centrifugation. No growth-factors were administered post-transplant. GVHD prophylaxis consisted of cyclosporin A (CyA) in one case, and CyA and methotrexate in five cases. All patients engrafted with a neutrophil count reaching more than 0.5 x 10(9)/L by day 12 to 21 post-transplant and a platelet count above 20 x 10(9)/L by day 6 to 41 post-transplant. Acute GVHD was clinical grade 0 (n = 2), I (n = 1), II (n = I), grade III (n = I) and grade IV (n = 1). One case presents an extensive chronic cutaneous GVHD and is currently being treated with methylprednisolone. In conclusion, allogeneic transplants using PBPC can be performed safely. This may result in a rapid neutrophil and platelet engraftment, without an apparent increased risk of GVHD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Female
  • Filgrastim
  • Graft vs Host Disease / etiology
  • Granulocyte Colony-Stimulating Factor / pharmacology
  • Hematopoiesis / drug effects
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cells / classification
  • Humans
  • Immunophenotyping
  • Leukapheresis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Leukemia, Myeloid / therapy
  • Male
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Recombinant Proteins
  • Salvage Therapy
  • Transplantation Conditioning
  • Transplantation, Homologous*
  • Treatment Outcome

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim