Comparison of four cytokine regimens for mobilization of peripheral blood stem cells: IL-3 alone and combined with GM-CSF or G-CSF

Bone Marrow Transplant. 1996 Feb;17(2):179-83.

Abstract

Improved methods for mobilization may reduce the number of aphereses required to collect adequate numbers of peripheral blood stem cells (PBSC) and hasten engraftment following high-dose therapy. Mobilization with cytokines alone enables engraftment after myeloablative therapy. The optimal cytokine regimen for mobilization has not been established. The study evaluated the effects of four interleukin-3-containing cytokine regimens administered during steady state hematopoiesis on PBSC mobilization in 30 patients with breast cancer or lymphoid malignancies. These regimens included IL-3 alone (Arm 1), sequential IL-3 --> G-GSF (Arm 2), sequential IL-3 --> GM-CSF (Arm 3) and combined IL-3 + G-CSF (Arm 4). Consecutive days of apheresis were performed until a target of 4-6 x 10(8) mononuclear cells/kg were collected. All patients received intravenous GM-CSF after PBSC infusion. Median days to an ANC > or = 500/ microliters in Arm 3(22 days) was significantly slower than for patients in Arm 2 (13 days) but not significantly different from patients in Arm 1 or Arm 4. There was no significant difference in platelet engraftment or days of hospitalization between the study arms. Addition of GM-CSF to IL-3-containing mobilization regimens results in collection of PBSC that lead to delayed engraftment. Further development of Arms 1, 2, and 4 appear warranted.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bone Marrow / drug effects*
  • Bone Marrow / radiation effects
  • Breast Neoplasms / blood
  • Busulfan / pharmacology
  • Carboplatin / pharmacology
  • Carmustine / pharmacology
  • Cyclophosphamide / pharmacology
  • Drug Administration Schedule
  • Drug Synergism
  • Etoposide / pharmacology
  • Female
  • Graft Survival
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Granulocyte Colony-Stimulating Factor / pharmacology*
  • Granulocyte-Macrophage Colony-Stimulating Factor / administration & dosage
  • Granulocyte-Macrophage Colony-Stimulating Factor / adverse effects
  • Granulocyte-Macrophage Colony-Stimulating Factor / pharmacology*
  • Hematopoietic Stem Cell Transplantation*
  • Hematopoietic Stem Cells / drug effects*
  • Humans
  • Interleukin-3 / administration & dosage
  • Interleukin-3 / adverse effects
  • Interleukin-3 / pharmacology*
  • Leukapheresis
  • Leukemia / blood
  • Leukocyte Count
  • Lymphoma / blood
  • Male
  • Middle Aged
  • Neutrophils
  • Prospective Studies
  • Thiotepa / pharmacology
  • Whole-Body Irradiation

Substances

  • Interleukin-3
  • Granulocyte Colony-Stimulating Factor
  • Etoposide
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Cyclophosphamide
  • Thiotepa
  • Carboplatin
  • Busulfan
  • Carmustine