The additive effect of peripheral blood stem cells, harvested with low-dose cyclophosphamide, to autologous bone marrow reinfusion on hematopoietic reconstitution after ablative chemotherapy in breast cancer patients with localized disease
de Graaf, H.; Mulder, N.H.; Willemse, P.H.; van der Graaf, W.T.; Sleijfer, D.T.; Zijlstra, J.G.; Elias, M.; Sibinga, C.T.; Vellenga, E.; de Vries, E.G.
Anticancer Research 15(6B): 2851-2856
1995
ISSN/ISBN: 0250-7005 PMID: 8669878 Document Number: 446000
The additive effect of peripheral blood stem cells (PBSCs) to autologous bone marrow transplantation (ABMT) on hematopoietic reconstitution, after ablative chemotherapy in patients with locally advanced breast cancer, was evaluated. Patients were treated with induction chemotherapy, followed by ablative chemotherapy consisting of mitoxantrone and thiotepa. Group I (n = 14) received ABMT and granulocyte macrophage-colony stimulating factor (GM-CSF), group II (n = 11) received ABMT, PBSCs and granulocyte-colony stimulating factor (GCSF). PBSCs were harvested after a low-dose cyclophosphamide (750 mg/m-2), followed by G-CSF. Stem cell harvest was routinely started 12 days after cyclophosphamide. Compared to group 1, group II showed a significant reduction in the median number of days for leukocytes lt 0. 5 times 10-9/l 4.5 days, leukocytes lt 1.0 times 10-9/l 5.5 days, platelets lt 20 times 10-9/l 9 days and platelets lt 40 times 10-9/l 12.5 days. The median number of transfusions of platelets fell from 11.5 to 7 and of red blood cells from 8.5 to 6. The median hospitalization duration declined from 40.5 to 30 days, fever above 38 degree C with 7.5 days, fever above 38.5 degree C with 4 days and antibiotic treatment with 8.5 days in group I versus group II. Improvement of hematological recovery, duration of fever and hospitalization was observed by the addition of PBSCs, obtainedafter a relatively low-dose cyclophosphamide and G-CSF and stem cell pheresis on fixed days, to autologous bone marrow and growth factor in the period after ablative chemotherapy.