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• W2085405541 abstract "In an attempt to offset the impaired hematopoietic progenitors' mobilization and collection which are frequently encountered in multiple myeloma (MM), we have started a pilot study to evaluate the ability of a combination of high-dose melphalan (HDM) and sequential s.c. administration of recombinant human interleukin 3 (rhIL-3) and rh-granulocyte colony-stimulating factor (G-CSF) to mobilize blood cells (BC) in MM patients. Two different schedules for administration were successively tested. Schedule A consisted of IL-3 (5 μg/kg/d) from day 7 to day 11 after HDM followed by G-CSF (5 μg/kg/d) from day 12 to day 20. Under schedule B, HDM was followed by IL-3 alone at the same dosage from day 1 to day 3, IL-3 and G-CSF (idem) from day 4 to day 7 and G-CSF alone from day 8 until completion of apheresis. Two patients (one previously untreated, one having received prior chemotherapy for one year) underwent schedule A; three patients (one previously untreated, two pretreated) underwent schedule B. The post-HDM aplasia was not shortened in schedule A patients in comparison to what we usually observed following HDM alone (25 days) correlated with a very moderate two- to three-fold CD34+ cell increase. Only one patient was further transplanted with apheresis products: the post-transplant granulocyte recovery was slower than usual (16 days versus 12 days) while platelet count never recovered over 20 × 109/l. In contrast, the post-HDM aplasia was significantly shortened in two of the schedule B patients (3 to 10 days) and was followed by a 25- to 165-fold increase in CD34+ cells. These two patients underwent further BC transplant which was characterized by shortened granulocyte count nadir (9 days) and accelerated sustained platelet recovery (10 to 14 days). In the third patient, the hematopoietic recovery was delayed longer after schedule B and was preceded by a transient appearance of consistent rates of plasmacytoid cells in peripheral blood, suggesting a cytokine-related mobilization of myeloma cells. However, schedule B, comprising an IL-3/G-CSF overlap, seems to better enhance BC mobilization than schedule A does and may offset the inhibition (induced by either the disease or melphalan) of hematopoiesis in high-grade MM. Yet, the risk of concomitant tumor cell mobilization will require extreme caution when developing cytokine mobilization in the future." @default.
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• W2085405541 date "1996-01-01" @default.
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• W2085405541 title "Mobilization of peripheral blood stem cells with chemotherapy and cytokines in multiple myeloma" @default.
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• W2085405541 doi "https://doi.org/10.1002/stem.5530130724" @default.
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