Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Progenitor Cell Mobilization

G-CSF Alone vs cyclophosphamide plus G-CSF in PBPC mobilization of patients with lymphoma: results depend on degree of previous pretreatment

Bone Marrow Transplantation volume 31, pages 747–754 (2003)Cite this article

Summary:

We performed a randomized study to compare ‘G-CSF alone’ (administered at dose of 10 mcg/kg/day) and ‘cyclophosphamide plus G-CSF’ (cyclophosphamide at dose of 4 g/m2 and G-CSF at dose of 10 μg/kg/day), as PBPC mobilization schedules in 52 patients with NHL or HD. Randomization was stratified according to the amount of previous chemotherapy (⩽2 and >2 lines of previous chemotherapy). Mean CD34+ cell peak in P.B., mean ‘Total CD34+ cells’ harvested and percentage of patients successfully mobilized, in the group mobilized with ‘G-CSF alone’ vs the group mobilized with ‘cyclophosphamide plus G-CSF’, were: 35.3 × 106 vs 45.8 × 106/l (P=0.3), 5.4 × 106 vs 6.8 × 106/kg (P>0.9) and 50 vs 61% (P=0.4). No differences were observed in the stratum of less pretreated patients. However, in the stratum of patients who had previously received more than two lines of chemotherapy, CD34+cell peak (P=0.05) and percentage of successful mobilization (P=0.01) were higher when ‘cyclophosphamide plus G-CSF’ was used. Using logistic regression, both age and mobilization with ‘G-CSF alone’ were significantly associated with a low CD34+ cell peak in P.B. However, in the stratum of less pretreated patients, only age was significantly associated with this risk.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. To LB, Roberts MM, Haylock DN et al. Comparison of haematological recovery times and supportive care requirements of autologous recovery phase peripheral blood stem cell transplants, autologous bone marrow transplants and allogeneic bone marrow transplants. Bone Marrow Transplant 1992; 9: 277–284.

    CAS  Google Scholar 

  2. Schmitz N, Linch DC, Dreger P et al. Randomized trial of filgrastim-mobilized peripheral blood progenitor cell transplantation versus autologous bone-marrow transplantation in lymphoma patients. Lancet 1996; 347: 353–357.

    Article  CAS  Google Scholar 

  3. Alegre A, Tomas JF, Martinez-Chomorro C et al. Comparison of peripheral blood progenitor cell mobilization in patients with multiple myeloma: high dose cyclophosphamide plus GM-CSF vs G-CSF alone. Bone Marrow Transplant 1997; 20: 211–217.

    Article  CAS  Google Scholar 

  4. Desikan KR, Barlogie B, Jagannath S et al. Comparable engraftment kinetics following peripheral blood stem cell infusion mobilized with granulocyte colony stimulating factor with or without cyclophosphamide in multiple myeloma. J Clin Oncol 1998; 6: 1547–1553.

    Article  Google Scholar 

  5. Akard LP, Thompson JM, Dugan MJ et al. Matched pair analysis of hemopoietic progenitor cell mobilisation using G-CSF vs cyclophosphamyde, etoposide and G-CSF in enhanced CD34+ cell collections are not necessarily cost-effective. Biol Blood Marrow Transplant 1999; 5: 379–385.

    Article  CAS  Google Scholar 

  6. Kroger N, Zeiter W, Hassan HT et al. Successful mobilisation of peripheral blood stem cells in heavily pretreated myeloma patients with G-CSF alone. Ann Hematol 1998; 76: 257–262.

    Article  CAS  Google Scholar 

  7. Grimaz S, Damiani D, Michieli M et al. Mobilisation of peripheral blood progenitor cells with G-CSF alone in lymphoma patients: steady state circulating progenitor cells count predicts the autograft yield. Haematologica 2000; 85: 102–103.

    CAS  Google Scholar 

  8. Feremans SW, Le Moine F, Ravolet C et al. Optimal blood stem cell mobilisation using 10 micrograms/kg granulocyte colony-stimulating factor (G-CSF) alone for high-dose melphalan intensification in multiple myeloma: an intrapatient controlled study. Am J Hematol 1994; 47: 135–138.

    Article  CAS  Google Scholar 

  9. Canales MA, Fernandez-Jimenez MC, Martin A et al. Identification of factors associated with poor peripheral blood progenitor cell mobilization in Hodgkin disease. Haematologica 2001; 86: 4949–4958.

    Google Scholar 

  10. Meisenberg B, Brhem T, Schmekel A et al. A combination of low-dose cyclophosphamide and colony stimulating factors is more cost-effective than granulocyte-colony stimulating factors alone in mobilizing peripheral blood stem and progenitor cells. Transfusion 1998; 38: 209–215.

    Article  CAS  Google Scholar 

  11. Bertolini F, Lanza A, Peccatori F et al. Hemopoietic progenitor cell collection and neoplastic cell contamination in breast cancer patient receiving chemotherapy plus granulocyte-colony stimulating factor (G-CSF) or G-CSF alone for mobilisation. Ann Oncol 1998; 9: 913–916.

    Article  CAS  Google Scholar 

  12. Kroger N, Zeiler W, Fehese N et al. Mobilizing peripheral blood stem cell with high-dose G-CSF alone is effective as with dexa-BEAM plus G-CSF in lymphoma patients. Br J Haematol 1998; 102: 1101–1106.

    Article  CAS  Google Scholar 

  13. Cesana C, Carlo-Stella C, Regazzi E et al. CD34 cells mobilized by cyclophosphamide and granulocyte colony-stimulating factor (G-CSF) are functionally different from CD34 cells mobilized by G-CSF. Bone Marrow Transplant 1998; 21: 561–568.

    Article  CAS  Google Scholar 

  14. Moskowitz CH, Glassman JR, Wuest D et al. Factors affecting mobilisation of peripheral blood progenitor cells in patients with lymphoma. Clin Cancer Res 1998; 4: 311–316.

    CAS  Google Scholar 

  15. Narayanasami U, Kanteli R, Morelli J et al. Randomized trial of filgrastim versus chemotherapy and filgrastim mobilization of hematopoietic progenitor cells for rescue in autologous transplantation. Blood 2001; 98: 2059–2064.

    Article  CAS  Google Scholar 

  16. Meldgaard Knudsen L, Jensen L, Gaarsdal E et al. A comparative study of sequential priming and mobilisation of progenitor cells with rh-G-CSF alone and high dose cyclophosphamide plus rh-G-CSF. Bone Marrow Transplant 2000; 26: 717–722.

    Article  CAS  Google Scholar 

  17. Fraipont V, Sautois B, Baudoux E et al. Successful mobilization of peripheral blood HPCs with G-CSF alone in patients failing to achieve sufficient numbers of CD34+ cells and/or CFU-GM with chemotherapy and G-CSF. Transfusion 2000; 40: 339–347.

    Article  CAS  Google Scholar 

  18. Weaver CH, Tauer K, Zhen B et al. Second attempts at mobilization of peripheral blood stem cell in patients with initial low CD34+ cell yields. J Hematother 1998; 7: 241–249.

    Article  CAS  Google Scholar 

  19. Gazitt Y, Shaughnessy P, Liu Q . Differential mobilization of CD34+ cells and lymphoma cells in non-Hodgkin's lymphoma patients mobilized with different growth factors. J Hematother Stem Cell Res 2001; 10: 167–176.

    Article  CAS  Google Scholar 

  20. Wills W, Chopra R, McMillan A et al. BEAM chemotherapy and autologous bone marrow transplantation for patients with relapsed or refractory Non-Hodgkin's lymphoma. J Clin Oncol 1995; 13: 588–595.

    Article  Google Scholar 

  21. To LB, Hylock DN . A comparative study of the phenotype and proliferative capacity of peripheral blood (PB) CD34+ cells mobilized by four different protocols and those of steady phase PB and bone marrow CD34+ cells. Blood 1994; 84: 2930–2939.

    CAS  Google Scholar 

  22. Gribben JG, Freedman AS, Neuberg D et al. Immunologic purging of marrow assessed by PCR before autologous bone marrow transplantation for B-cell Lymphoma. N Engl J Med 1991; 325: 1525–1535.

    Article  CAS  Google Scholar 

  23. Bierman PJ, Sweetenauham T, Loberizza F et al. Syngenic hematopoietic stem cell transplantation for Non Hodgkin's Lymphoma (NHL): comparison with allogenic and autologous transplants suggests a role for purging. Proc Am Soc Clin Oncol 2001; 20: 1 (abstract 15).

    Google Scholar 

  24. Jaquy C, Soree A, Lambert F et al. A quantitative study of peripheral blood stem cell contamination in diffuse large-cell non-Hodgkin's lymphoma: one-half of patients significantly mobilize malignant cells. Br J Haematol 2000; 110: 631–637.

    Article  Google Scholar 

  25. Gribben JG, Freedman AS, Woo SD et al. All advanced stage non-Hodgkin lymphomas with polymerase chain reaction amplifiable breakpoint of bcl-2 have residual cells containing the bcl-2 rearrangement at evaluation and after treatment. Blood 1991; 78: 3275–3280.

    CAS  Google Scholar 

  26. Gidali J, Feher I . Lymphoma cell contamination of PBPC: a murine model. Bone Marrow Trasplant 1999; 24: 617–620.

    Article  CAS  Google Scholar 

  27. Demirkazik A, Kessinger A, Armitage JO et al. Progenitor and lymphoma cells in blood stem cell harvests: impact on survival following transplantation. Bone Marrow Transplant 2001; 28: 207–212.

    Article  CAS  Google Scholar 

  28. Passos-Coelho JL, Ross AA, Kahn DJ et al. Similar breast cancer cell contamination of single-day peripheral blood progenitor cell collections obtained after priming with hemopoietic growth factor alone or after cyclophosphamide followed by growth factor. J Clin Oncol 1996; 14: 2569–2575.

    Article  CAS  Google Scholar 

  29. Rosillo MC, Ortuno F, Moraleda JM et al. Immune recovery after autologous or rhG-CSF primed PBPC transplantation. Eur J Haematol 1996; 56: 301–307.

    Article  CAS  Google Scholar 

  30. Porrata LF, Gertz MA, Inwards DJ et al. Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or Non Hodgkin's lymphoma. Blood 2001; 98: 579–585.

    Article  CAS  Google Scholar 

  31. Akard L . Optimum methods to mobilize stem cells. J Clin Oncol 2000; 18: 3063.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are grateful to Mike Wilkinson for the English translation of the manuscript.

Author information

Authors and Affiliations

  1. Division of Haematology and Bone Marrow Transplantation, Ospedale Ferrarotto, Catania, Italy

    G Milone, S Leotta, F Indelicato, S Mercurio, G Moschetti, F Di Raimondo, A Tornello, U Consoli, G Guido & R Giustolisi

Authors
  1. G Milone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Leotta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F Indelicato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S Mercurio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G Moschetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F Di Raimondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A Tornello
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. U Consoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. G Guido
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. R Giustolisi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Milone, G., Leotta, S., Indelicato, F. et al. G-CSF Alone vs cyclophosphamide plus G-CSF in PBPC mobilization of patients with lymphoma: results depend on degree of previous pretreatment. Bone Marrow Transplant 31, 747–754 (2003). https://doi.org/10.1038/sj.bmt.1703912

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703912

Keywords

This article is cited by

Search

Advanced search

Quick links