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Progenitor Cell Mobilisation

A randomised study comparing peripheral blood progenitor mobilisation using intermediate-dose cyclophosphamide plus lenograstim with lenograstim alone

Bone Marrow Transplantation volume 34, pages 399–403 (2004)Cite this article

Summary:

We conducted a prospective randomised study to compare the efficiency of out-patient progenitor cell mobilisation using either intermediate-dose cyclophosphamide (2 g/m2) and lenograstim at 5 μg/kg (Cyclo-G-CSF group, n=39) or lenograstim alone at 10 μg/kg (G-CSF group, n=40). The end points were to compare the impact of the two regimens on mobilisation efficiency, morbidity, time spent in hospital, the number of apheresis procedures required and engraftment kinetics. Successful mobilisation was achieved in 28/40 (70%) in the G-CSF group vs 22/39 (56.4%) for Cyclo-G-CSF (P=0.21). The median number of CD34+ cells mobilised was 2.3 × 106/kg and 2.2 × 106/kg for G-CSF and cyclo-G-CSF arms following a median of two apheresis procedures. Nausea and vomiting and total time spent in the hospital during mobilisation were significantly greater after Cyclo-G-CSF (P<0.05). Rapid neutrophil and platelet engraftment was achieved in all transplanted patients in both groups. In conclusion, G-CSF at 10 μg/kg was as efficient at mobilising progenitor cells as a combination of cyclophosphamide and G-CSF with reduced hospitalisation and side effects and prompt engraftment. When aggressive in-patient cytoreductive regimens are not required to both control disease and generate progenitor cells, the use of G-CSF alone appears preferable to combination with intermediate-dose cyclophosphamide.

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Authors and Affiliations

  1. Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK

    M Karanth, S Chakrabarti, R A Lovell, C Harvey, K Holder, C D Fegan & D W Milligan

  2. Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK

    C C McConkey

  3. Stem Cell Laboratory, National Blood Transfusion Services, Birmingham, UK

    D McDonald

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  1. M Karanth
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  2. S Chakrabarti
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  3. R A Lovell
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  4. C Harvey
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  5. K Holder
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  6. C C McConkey
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  7. D McDonald
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  8. C D Fegan
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Correspondence to D W Milligan.

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Karanth, M., Chakrabarti, S., Lovell, R. et al. A randomised study comparing peripheral blood progenitor mobilisation using intermediate-dose cyclophosphamide plus lenograstim with lenograstim alone. Bone Marrow Transplant 34, 399–403 (2004). https://doi.org/10.1038/sj.bmt.1704598

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