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Ancestim associated with Filgrastim and/or chemotherapy can improve blood progenitor yields in patients who previously failed mobilisation

Bone Marrow Transplantation volume 35, page 1019 (2005)Cite this article

Da Silva et al1 conclude that remobilisation with a combination of Filgrastim and Ancestim (recombinant human stem cell factor, AMGEN) does not allow for the collection of an adequate dose of blood progenitor cells (BPC) in patients who failed an earlier BPC mobilisation attempt. However, their data show that four of the 20 patients actually had ⩾3 × 106 CD34+ cells/kg collected on the study. Most transplanters would feel comfortable with proceeding to autologous PBPC transplant with this dose of cells. It therefore appears that their strategy is successful in 20% of patients, and this is a worthwhile result in a group of patients who are by definition difficult to mobilise.

In 1999/2000, a multicentric, phase I/II study (see Appendix A for ‘participating centres’) investigated the possibility of remobilising patients with haematological malignancies, by adding Ancestim 20 μg/kg/day to the mobilisation regimen they had previously failed. Patients were eligible if they failed to mobilise >10 CD34+ cells/μl into the blood, or had a total CD34+ cell yield of 0.3–1 × 106/kg at the previous mobilisation attempt. In all, 32 patients with myeloma, Hodgkin's disease, and non-Hodgkin's lymphoma were enrolled, of which 12 had failed Filgrastim-only mobilisation, while 20 failed to mobilise following a combination of chemotherapy and Filgrastim. Remobilisation took place at a median of 60 days (range 7–173 days) after the initial attempt. One patient was withdrawn due to a serious adverse event.

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References

  1. Da Silva MG, Pimentel P, Carvalhais A et al. Ancestim (recombinant human stem cell factor, SCF) in association with filgrastim does not enhance chemotherapy and/or growth factor-induced peripheral blood progenitor cell (PBPC) mobilisation in patients with a prior insufficient PBPC collection. Bone Marrow Transplant 2004; 34: 683–691.

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  2. To LB, Bashford J, Durrant S et al. Successful mobilisation of peripheral blood stem cells after addition of ancestim (stem cell factor) in patients who had failed a prior mobilisation with filgrastim (granulocyte colony-stimulating factor) alone or with chemotherapy plus filgrastim. Bone Marrow Transplant 2003; 31: 371–378.

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Author information

Authors and Affiliations

  1. King's College Hospital, London, UK

    A Mijovic & G J Mufti

  2. Nottingham City Hospital, UK

    N Russell

  3. Royal Liverpool University Hospital, UK

    R E Clark

  4. Belfast City Hospital, Northern Ireland, UK

    T C M Morris

  5. St James' Hospital, Dublin, Ireland

    P Browne

  6. St Vincent's Hospital, Dublin, Ireland

    J Crown

  7. Royal Marsden Hospital, Sutton, Surrey, UK

    M Potter

Authors
  1. A Mijovic
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  2. N Russell
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  3. R E Clark
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  4. T C M Morris
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  5. P Browne
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  6. J Crown
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  7. M Potter
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  8. G J Mufti
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Appendix A

Appendix A

Participating centers

King's College Hospital, London (Professor GJ Mufti, Dr A Mijovic), Royal Marsden Hospital, London (Professor R Powles), Royal Free Hospital, London (Dr M Potter), Nottingham City Hospital (Professor N Russell), St James'Hospital, Dublin (Dr P Browne), St Vincent's Hospital, Dublin (Dr J Crown), Belfast City Hospital (Dr TCM Morris) and Royal Liverpool University Hospitals (Dr RE Clark).

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Mijovic, A., Russell, N., Clark, R. et al. Ancestim associated with Filgrastim and/or chemotherapy can improve blood progenitor yields in patients who previously failed mobilisation. Bone Marrow Transplant 35, 1019 (2005). https://doi.org/10.1038/sj.bmt.1704950

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