Peripheral blood progenitor cell mobilization using stem cell factor in combination with filgrastim in breast cancer patients
Peripheral blood progenitor cell mobilization using stem cell factor in combination with filgrastim in breast cancer patients
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DOI：
10.1182/blood.v90.8.2939
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发表时间：
1997-10-15
期刊：
影响因子：
20.3
通讯作者：
McNiece, IK
中科院分区：
文献类型：
--
作者：
Glaspy, JA;Shpall, EJ;McNiece, IK
对215例高危乳腺癌患者联合应用干细胞因子(SCF)和非格列汀动员外周血祖细胞(PBPC)的安全性、最佳剂量和方案进行了研究。患者接受非格雷替单用(10mU g/kg/d，共7天)或非格司提单用10 mU/kg/d+SCF 5~30µg/kg/d，疗程7、10或13天。对SCF患者预先给予抗过敏预防。在细胞因子治疗的最后3天进行白细胞分离，在大剂量化疗和输注外周血祖细胞后，给予非格列汀10mU g/kg/d，直到中性粒细胞绝对计数恢复。接受联合治疗的患者CD34(+)细胞的中位数高于单独接受治疗的患者(7.7v3.2x10(6)/kg，P<；0.05)。20mU/kg/d SCF(中位数，7.9×10(6)/kg)和25mU/kg/d SCF(中位数，13.6×10(6)/kg)7天联合用药组CD34(+)细胞数显著高于单用非格雷替组(中位数，3.2×10(6)/kg)。SCF和非格列格替姆的给药时间(7、10或13天)对CD34(+)细胞产量没有显著影响。单独使用非格列西汀或联合使用细胞因子动员的治疗组在PBPC输注后的造血植入和总存活率相似。总之，这项研究的结果表明，SCF疗法提高了CD34(+)细胞的产量，并与与非格列汀联合动员PBPC时可控制的毒性水平有关。20mU/kg/d的SCF和10mU/kg/d的非格雷替加从第5天开始每日采集的组合被选为动员外周血祖细胞的最佳剂量和方案。(C)1997年由美国血液病学会主办。
The safety and optimal dose and schedule of stem cell factor (SCF) administered in combination with filgrastim for the mobilization of peripheral blood progenitor cells (PBPCs) was determined in 215 patients with high-risk breast cancer. Patients received either filgrastim alone (10 mu g/kg/d for 7 days) or the combination of 10 mu g/kg/d filgrastim and 5 to 30 mu g/kg/d SCF for either 7, 10, or 13 days. SCF patients were premedicated with antiallergy prophylaxis. Leukapheresis was performed on the final 3 days of cytokine therapy and, after high-dose chemotherapy and infusion of PBPCs, patients received 10 mu g/kg/d filgrastim until absolute neutrophil count recovery. The median number of CD34(+) cells collected was greater for patients receiving the combination of filgrastim and SCF, at doses greater than 10 mu g/kg/d, than for those receiving filgrastim alone (7.7 v 3.2 x 10(6)/kg, P < .05). There were significantly (P < .05) more CD34(+) cells harvested for the 20 mu g/kg/d SCF (median, 7.9 x 10(6)/kg) and 25 mu g/kg/d SCF (median, 13.6 x 10(6)/kg) 7-day combination groups than for the filgrastim alone patients (median, 3.2 x 10(6)/kg). The duration of administration of SCF and filgrastim (7, 10, or 13 days) did not significantly affect CD34(+) cell yield. Treatment groups mobilized with filgrastim alone or with the cytokine combination had similar hematopoietic engraftment and overall survival after PBPC infusion. In conclusion, the results of this study indicate that SCF therapy enhances CD34(+) cell yield and is associated with manageable levels of toxicity when combined with filgrastim for PBPC mobilization. The combination of 20 mu g/kg/d SCF and 10 mu g/kg/d filgrastim with daily apheresis beginning on day 5 was selected as the optimal dose and schedule for the mobilization of PBPCs. (C) 1997 by The American Society of Hematology.